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Volume 9, Issue 5

Genomic epidemiology of isolated from bloodstream infections in South America during 2019 supports regional surveillance Open Access

Abstract

remains one of the leading causes of infections worldwide and a common cause of bacteraemia. However, studies documenting the epidemiology of in South America using genomics are scarce. We hereby report on the largest genomic epidemiology study to date of both methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) in South America, conducted by the StaphNET-SA network. We characterised 404 genomes recovered from a prospective observational study of bacteraemia in 58 hospitals from Argentina, Bolivia, Brazil, Paraguay and Uruguay between April and October 2019. We show that a minority of isolates are phenotypically multi-drug resistant (5.2%), but more than a quarter are resistant to macrolide–lincosamide–streptogramin B (MLSb). MSSA were more genetically diverse than MRSA. Lower rates of associated antimicrobial resistance in community-associated(CA)-MRSA versus hospital-associated (HA)-MRSA were found in association with three genotypes dominating the MRSA population: CC30-MRSA-IVc-, CC5-MRSA-IV- and CC8-MRSA-IVc--COMER+. These are historically from a CA origin, carry on average fewer antimicrobial resistance determinants, and often lack key virulence genes. Surprisingly, CC398-MSSA- related to the CC398 human-associated lineage is widely disseminated throughout the region, and is described here for the first time as the most prevalent MSSA lineage in South America. Moreover, CC398 strains carrying (largely responsible for the MLSb resistance rates of MSSA strains: inducible iMLSb phenotype) and (related to triclosan resistance) were recovered from both CA and HA origin. The frequency of MRSA and MSSA lineages differed between countries but the most prevalent genotypes are high-risk clones widely distributed in the South American region without a clear country-specific phylogeographical structure. Therefore, our findings underline the need for continuous genomic surveillance by regional networks such as StaphNET-SA. This article contains data hosted by Microreact.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): CC30 , CC398 , CC5 , CC8 , MRSA , MSSA , S. aureus and South America
Funding
This study was supported by the:
  • National Institute for Health and Care Research (Award Global Health Research Unit on genomic Surveillance of AMR (16_136_111))
    • Principle Award Recipient: DavidM. Aanensen
  • Agencia Nacional de Promoción Científica y Tecnológica (Award Préstamo BID PICT-2018-03068)
    • Principle Award Recipient: SabrinaDi Gregorio
  • Agencia Nacional de Promoción Científica y Tecnológica (Award Préstamo BID PICT-2016-1726 and PICT2020-03132)
    • Principle Award Recipient: MartaMollerach
  • Consejo Nacional de Investigaciones Científicas y Técnicas (Award PIP 2015 11220150100694CO)
    • Principle Award Recipient: MartaMollerach
  • Universidad de Buenos Aires (Award UBACYT 2018-2020-20020170100665BA)
    • Principle Award Recipient: MartaMollerach
  • Academy of Medical Sciences (Award GCRFNG100309)
    • Principle Award Recipient: MartaMollerach
© 2023 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License.
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Genomic epidemiology of Staphylococcus aureus isolated from bloodstream infections in South America during 2019 supports regional surveillance
M Gen 9, 001020 (2023); https://doi.org/10.1099/mgen.0.001020
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