1887

Abstract

Introduction:

Methicillin‐resistant (MRSA) of clonal complex (CC) 398 has emerged in livestock across Europe over the past 10 years.

Case presentation:

Case 1 was a patient with a history of destructive chronic polyarthritis and immunosuppressive therapy who presented with dyspnoea and pain in the shoulders, back and hips. Microbiological analysis of tissue samples, punctures and blood cultures revealed MRSA. Echocardiography showed mitral valve endocarditis. The patient was treated with daptomycin and fosfomycin. Case 2 was a patient presenting with pneumonia after lung transplantation. Respiratory specimens and perianal swabs revealed MRSA. The patient was treated with teicoplanin and linezolid. The patients did not recover from their infections and died. The isolates belonged to types t2576 (case 1) and t011 (case 2), to sequence type 398 within CC398 as determined by multilocus sequence typing and to staphylococcal cassette chromosome type 5. An IdentiBAC Microarray revealed the absence of a bacteriophage integrating into the gene indicative of the livestock origin of the isolates. In 2013, 170 of 534 MRSA cases (31.8 %) among inpatients of the University Hospital Münster, Germany, were caused by closely related types clustering in one ‐CC indicative of CC398. Two of 12 MRSA isolates from blood cultures (16.7 %) were caused by isolates associated with MRSA CC398.

Conclusion:

Livestock‐associated MRSA CC398 is emerging as a cause of human infections. This observation is alarming and should inspire future efforts to control MRSA in livestock, forestall community spread and monitor changes of the occurrence of MRSA CC398 among cases of human infections.

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2015-04-01
2019-08-25
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References

  1. Enright M.C. , Day N.P. , Davies C.E. , Peacock S.J. , Spratt B.G. . ( 2000; ). Multilocus sequence typing for characterization of methicillin‐resistant and methicillin‐susceptible clones of Staphylococcus aureus . . J Clin Microbiol 38:, 1008–1015.
    [Google Scholar]
  2. European Food Safety Authority ( 2009; ). Analysis of the baseline survey on the prevalence of methicillin‐resistant Staphylococcus aureus (MRSA) in holdings with breeding pigs, in the EU, 2008, Part A: MRSA prevalence estimates; on request of the European Commission. . EFSA Journal 7:, 1376.
    [Google Scholar]
  3. Köck R. , Harlizius J. , Bressan N. , Laerberg R. , Wieler L.H. , Witte W. , Deurenberg R.H. , Voss A. , Becker K. , Friedrich A.W. . ( 2009; ). Prevalence and molecular characteristics of methicillin‐resistant Staphylococcus aureus (MRSA) among pigs on German farms and import of livestock‐related MRSA into hospitals. . Eur J Clin Microbiol Infect Dis 28:, 1375–1382.[CrossRef]
    [Google Scholar]
  4. Köck R. , Loth B. , Koksal M. , Schulte‐Wulwer J. , Harlizius J. , Friedrich A.W. . ( 2012; ). Persistence of nasal colonization with livestock‐associated methicillin‐resistant Staphylococcus aureus in pig farmers after holidays from pig exposure. . Appl Environ Microbiol 78:, 4046–4047.[CrossRef]
    [Google Scholar]
  5. Köck R. , Schaumburg F. , Mellmann A. , Koksal M. , Jurke A. , Becker K. , Friedrich A.W. . ( 2013; ). Livestock‐associated methicillin‐resistant Staphylococcus aureus (MRSA) as causes of human infection and colonization in Germany. . PLoS ONE 8:, e55040.[CrossRef]
    [Google Scholar]
  6. 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]
    [Google Scholar]
  7. Lozano C. , Aspiroz C. , Ezpeleta A.I. , Gomez‐Sanz E. , Zarazaga M. , Torres C. . ( 2011; ). Empyema caused by MRSA ST398 with atypical resistance profile, Spain. . Emerg Infect Dis 17:, 138–140.[CrossRef]
    [Google Scholar]
  8. Mellmann A. , Friedrich A.W. , Rosenkotter N. , Rothganger J. , Karch H. , Reintjes R. , Harmsen D. . ( 2006; ). Automated DNA sequence‐based early warning system for the detection of methicillin‐resistant Staphylococcus aureus outbreaks. . PLoS Med 3:, e33.[CrossRef]
    [Google Scholar]
  9. Monecke S. , Slickers P. , Ehricht R. . ( 2008; ). Assignment of Staphylococcus aureus isolates to clonal complexes based on microarray analysis and pattern recognition. . FEMS Immunol Med Microbiol 53:, 237–251.[CrossRef]
    [Google Scholar]
  10. Pan A. , Battisti A. , Zoncada A. , Bernieri F. , Boldini M. , Franco A. , Giorgi M. , Iurescia M. , Lorenzotti S. . other authors ( 2009; ). Community‐acquired methicillin‐resistant Staphylococcus aureus ST398 infection, Italy. . Emerg Infect Dis 15:, 845–847.[CrossRef]
    [Google Scholar]
  11. Price L.B. , Stegger M. , Hasman H. , Aziz M. , Larsen J. , Andersen P.S. , Pearson T. , Waters A.E. , Foster J.T. . other authors ( 2012; ). Staphylococcus aureus CC398: host adaptation and emergence of methicillin resistance in livestock. . MBio 3:, e00305–11.[CrossRef]
    [Google Scholar]
  12. Schijffelen M.J. , Boel C.H. , van Strijp J.A. , Fluit A.C. . ( 2010; ). Whole genome analysis of a livestock‐associated methicillin‐resistant Staphylococcus aureus ST398 isolate from a case of human endocarditis. . BMC Genomics 11:, 376.[CrossRef]
    [Google Scholar]
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