1887

Abstract

, including meticillin-sensitive and -resistant (MSSA and MRSA, respectively), is associated with severe nosocomial human infections. This study aimed to investigate the molecular profile, including the dynamic changes and genotype/phenotype correlation, of isolates recovered from different clinical specimens of inpatients with infection over a 6-year span at a teaching hospital in Shanghai, China. Between 2005 and 2010, a random sample of 610 unique isolates was collected from different clinical samples of inpatients with infection for molecular and antibiotic susceptibility analysis. The results showed that, among the 610 isolates, 20 sequence types (STs) determined by multi-locus sequence typing (primarily ST239, ST5, ST7, ST188 and ST398) and 52 types (primarily t002, t037, t030 and t601) were found. In total, 444 isolates (72.8 %) were MRSA and 166 (27.2 %) were MSSA. ST239-MRSA-III- t037 and ST5-MRSA-II- t002 were the predominant MRSA clones. From 2005 to 2010, t002, t037 and their corresponding STs (ST5 and ST239) were the most frequent clones among all of the isolates and showed the most resistant phenotypes to various antibiotics. Generally, the different genotypes showed different drug resistance rates, but no isolates were resistant to vancomycin, teicoplanin or linezolid. The profiles of virulence and resistance genes differed by genetic background, with the ST239 and ST5 strains showing higher resistance rates to gentamicin, cefoxitin, ampicillin, cefazolin, erythromycin, clindamycin and levofloxacin than strains of other types. Moreover, the antiseptic resistance genes were generally associated with these two types. The prevalence of STs was different among different clinical specimens and also changed by year. Recently (2009–2010), the distribution of predominant MRSA clones decreased, whilst the prevalence of non-predominant MSSA clones increased, especially for the isolates causing bacteraemia. Continual monitoring of clinical isolates is necessary to develop and maintain an effective strategy against infection in the hospital setting.

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2013-02-01
2019-10-19
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References

  1. Al-Talib H., Hasan H., Yean C. Y., Al-Ashwal S. M., Ravichandran M.. ( 2011;). Fatal necrotizing pneumonia caused by Panton–Valentine leukocidin-producing hospital-acquired Staphylococcus aureus: a case report. . Jpn J Infect Dis 64:, 58–60.[PubMed]
    [Google Scholar]
  2. Cadilla A., David M. Z., Daum R. S., Boyle-Vavra S.. ( 2011;). Association of high-level mupirocin resistance and multidrug-resistant methicillin-resistant Staphylococcus aureus at an academic center in the midwestern United States. . J Clin Microbiol 49:, 95–100. [CrossRef][PubMed]
    [Google Scholar]
  3. Campbell S. J., Deshmukh H. S., Nelson C. L., Bae I. G., Stryjewski M. E., Federspiel J. J., Tonthat G. T., Rude T. H., Barriere S. L.. & other authors ( 2008;). Genotypic characteristics of Staphylococcus aureus isolates from a multinational trial of complicated skin and skin structure infections. . J Clin Microbiol 46:, 678–684. [CrossRef][PubMed]
    [Google Scholar]
  4. Chen H., Liu Y., Jiang X., Chen M., Wang H.. ( 2010;). Rapid change of methicillin-resistant Staphylococcus aureus clones in a Chinese tertiary care hospital over a 15-year period. . Antimicrob Agents Chemother 54:, 1842–1847. [CrossRef][PubMed]
    [Google Scholar]
  5. CLSI ( 2010;). Performance Standards for Antimicrobial Susceptibility Testing, 20th Informational Supplement M100-S20. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  6. Diep B. A., Carleton H. A., Chang R. F., Sensabaugh G. F., Perdreau-Remington F.. ( 2006;). Roles of 34 virulence genes in the evolution of hospital- and community-associated strains of methicillin-resistant Staphylococcus aureus. . J Infect Dis 193:, 1495–1503. [CrossRef][PubMed]
    [Google Scholar]
  7. Dryden M. S.. ( 2009;). Skin and soft tissue infection: microbiology and epidemiology. . Int J Antimicrob Agents 34: (Suppl. 1), S2–S7. [CrossRef][PubMed]
    [Google Scholar]
  8. Fan J., Shu M., Zhang G., Zhou W., Jiang Y., Zhu Y., Chen G., Peacock S. J., Wan C.. & other authors ( 2009;). Biogeography and virulence of Staphylococcus aureus. . PLoS ONE 4:, e6216. [CrossRef][PubMed]
    [Google Scholar]
  9. Gillet Y., Issartel B., Vanhems P., Fournet J. C., Lina G., Bes M., Vandenesch F., Piémont Y., Brousse N.. & other authors ( 2002;). Association between Staphylococcus aureus strains carrying gene for Panton–Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. . Lancet 359:, 753–759. [CrossRef][PubMed]
    [Google Scholar]
  10. Grundmann H., Aires-de-Sousa M., Boyce J., Tiemersma E.. ( 2006;). Emergence and resurgence of meticillin-resistant Staphylococcus aureus as a public-health threat. . Lancet 368:, 874–885. [CrossRef][PubMed]
    [Google Scholar]
  11. Hanssen A. M., Ericson Sollid J. U.. ( 2006;). SCCmec in staphylococci: genes on the move. . FEMS Immunol Med Microbiol 46:, 8–20. [CrossRef][PubMed]
    [Google Scholar]
  12. Jarraud S., Mougel C., Thioulouse J., Lina G., Meugnier H., Forey F., Nesme X., Etienne J., Vandenesch F.. ( 2002;). Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. . Infect Immun 70:, 631–641. [CrossRef][PubMed]
    [Google Scholar]
  13. Kondo Y., Ito T., Ma X. X., Watanabe S., Kreiswirth B. N., Etienne J., Hiramatsu K.. ( 2007;). Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec, ccr, and major differences in junkyard regions. . Antimicrob Agents Chemother 51:, 264–274. [CrossRef][PubMed]
    [Google Scholar]
  14. Koreen L., Ramaswamy S. V., Graviss E. A., Naidich S., Musser J. M., Kreiswirth B. N.. ( 2004;). spa Typing method for discriminating among Staphylococcus aureus isolates: implications for use of a single marker to detect genetic micro- and macrovariation. . J Clin Microbiol 42:, 792–799. [CrossRef][PubMed]
    [Google Scholar]
  15. Li M., Du X., Villaruz A. E., Diep B. A., Wang D., Song Y., Tian Y., Hu J., Yu F.. & other authors ( 2012;). MRSA epidemic linked to a quickly spreading colonization and virulence determinant. . Nat Med 18:, 816–819. [CrossRef][PubMed]
    [Google Scholar]
  16. Maiden M. C., Bygraves J. A., Feil E., Morelli G., Russell J. E., Urwin R., Zhang Q., Zhou J., Zurth K.. & other authors ( 1998;). Multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. . Proc Natl Acad Sci U S A 95:, 3140–3145. [CrossRef][PubMed]
    [Google Scholar]
  17. Marimón J. M., Villar M., García-Arenzana J. M., Caba I. L., Pérez-Trallero E.. ( 2012;). Molecular characterization of Staphylococcus aureus carrying the Panton–Valentine leucocidin genes in northern Spain. . J Infect 64:, 47–53. [CrossRef][PubMed]
    [Google Scholar]
  18. Mayer S., Boos M., Beyer A., Fluit A. C., Schmitz F. J.. ( 2001;). Distribution of the antiseptic resistance genes qacA, qacB and qacC in 497 methicillin-resistant and -susceptible European isolates of Staphylococcus aureus. . J Antimicrob Chemother 47:, 896–897. [CrossRef][PubMed]
    [Google Scholar]
  19. McNeil J. C., Hulten K. G., Kaplan S. L., Mason E. O.. ( 2011;). Mupirocin resistance in Staphylococcus aureus causing recurrent skin and soft tissue infections in children. . Antimicrob Agents Chemother 55:, 2431–2433. [CrossRef][PubMed]
    [Google Scholar]
  20. Mostofsky E., Lipsitch M., Regev-Yochay G.. ( 2011;). Is methicillin-resistant Staphylococcus aureus replacing methicillin-susceptible S. aureus?. J Antimicrob Chemother 66:, 2199–2214. [CrossRef][PubMed]
    [Google Scholar]
  21. Noguchi N., Nakaminami H., Nishijima S., Kurokawa I., So H., Sasatsu M.. ( 2006;). Antimicrobial agent of susceptibilities and antiseptic resistance gene distribution among methicillin-resistant Staphylococcus aureus isolates from patients with impetigo and staphylococcal scalded skin syndrome. . J Clin Microbiol 44:, 2119–2125. [CrossRef][PubMed]
    [Google Scholar]
  22. Nulens E., Stobberingh E. E., van Dessel H., Sebastian S., van Tiel F. H., Beisser P. S., Deurenberg R. H.. ( 2008;). Molecular characterization of Staphylococcus aureus bloodstream isolates collected in a Dutch University Hospital between 1999 and 2006. . J Clin Microbiol 46:, 2438–2441. [CrossRef][PubMed]
    [Google Scholar]
  23. Ritz N., Curtis N.. ( 2012;). The role of Panton–Valentine leukocidin in Staphylococcus aureus musculoskeletal infections in children. . Pediatr Infect Dis J 31:, 514–518. [CrossRef][PubMed]
    [Google Scholar]
  24. Shopsin B., Gomez M., Montgomery S. O., Smith D. H., Waddington M., Dodge D. E., Bost D. A., Riehman M., Naidich S., Kreiswirth B. N.. ( 1999;). Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. . J Clin Microbiol 37:, 3556–3563.[PubMed]
    [Google Scholar]
  25. Simor A. E., Stuart T. L., Louie L., Watt C., Ofner-Agostini M., Gravel D., Mulvey M., Loeb M., McGeer A.. & other authors ( 2007;). Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian hospitals. . Antimicrob Agents Chemother 51:, 3880–3886. [CrossRef][PubMed]
    [Google Scholar]
  26. Strommenger B., Braulke C., Heuck D., Schmidt C., Pasemann B., Nübel U., Witte W.. ( 2008;). spa Typing of Staphylococcus aureus as a frontline tool in epidemiological typing. . J Clin Microbiol 46:, 574–581. [CrossRef][PubMed]
    [Google Scholar]
  27. Valentin-Domelier A. S., Girard M., Bertrand X., Violette J., François P., Donnio P. Y., Talon D., Quentin R., Schrenzel J., van der Mee-Marquet N..Bloodstream Infection Study Group of the Réseau des Hygiénistes du Centre (RHC) ( 2011;). Methicillin-susceptible ST398 Staphylococcus aureus responsible for bloodstream infections: an emerging human-adapted subclone?. PLoS ONE 6:, e28369. [CrossRef][PubMed]
    [Google Scholar]
  28. Wang C., Cai P., Zhan Q., Mi Z., Huang Z., Chen G.. ( 2008a;). Distribution of antiseptic-resistance genes qacA/B in clinical isolates of meticillin-resistant Staphylococcus aureus in China. . J Hosp Infect 69:, 393–394. [CrossRef][PubMed]
    [Google Scholar]
  29. Wang H., Liu Y., Sun H., Xu Y., Xie X., Chen M.. ( 2008b;). In vitro activity of ceftobiprole, linezolid, tigecycline, and 23 other antimicrobial agents against Staphylococcus aureus isolates in China. . Diagn Microbiol Infect Dis 62:, 226–229. [CrossRef][PubMed]
    [Google Scholar]
  30. Wu D., Li X., Yang Y., Zheng Y., Wang C., Deng L., Liu L., Li C., Shang Y.. & other authors ( 2011;). Superantigen gene profiles and presence of exfoliative toxin genes in community-acquired meticillin-resistant Staphylococcus aureus isolated from Chinese children. . J Med Microbiol 60:, 35–45. [CrossRef][PubMed]
    [Google Scholar]
  31. Xu B. L., Zhang G., Ye H. F., Feil E. J., Chen G. R., Zhou X. M., Zhan X. M., Chen S. M., Pan W. B.. ( 2009;). Predominance of the Hungarian clone (ST 239-III) among hospital-acquired meticillin-resistant Staphylococcus aureus isolates recovered throughout mainland China. . J Hosp Infect 71:, 245–255. [CrossRef][PubMed]
    [Google Scholar]
  32. Yamada K., Yanagihara K., Hara Y., Araki N., Harada Y., Morinaga Y., Matsuda J., Izumikawa K., Seki M.. & other authors ( 2011;). Clinical features of bacteremia caused by methicillin-resistant Staphylococcus aureus in a tertiary hospital. . Tohoku J Exp Med 224:, 61–67. [CrossRef][PubMed]
    [Google Scholar]
  33. Yu F., Chen Z., Liu C., Zhang X., Lin X., Chi S., Zhou T., Chen Z., Chen X.. ( 2008;). Prevalence of Staphylococcus aureus carrying Panton–Valentine leukocidin genes among isolates from hospitalised patients in China. . Clin Microbiol Infect 14:, 381–384. [CrossRef][PubMed]
    [Google Scholar]
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