Emergence of a mupirocin-resistant, methicillin-susceptible Staphylococcus aureus clone associated with skin and soft tissue infections in Greece
Open Access
- 3 July 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Microbiology
- Vol. 21 (1), 1-10
- https://doi.org/10.1186/s12866-021-02272-5
Abstract
Background: Staphylococcus aureus causes various infections, including skin and soft tissue infections (SSTIs). In this study, methicillin-susceptible S. aureus (MSSA) from SSTIs among patients in three tertiary-care hospitals in Greece were studied in terms of antimicrobial resistance, clonal distribution, toxin and adhesin genes carriage. Results: During a five-year period (2014–2018), 6145 S. aureus were recovered from 13,244 patients with SSTIs and tested for antimicrobial susceptibility. MSSA were 4806 (78.21 %) including 1484 isolates with mupirocin minimum inhibitory concentration (MIC) > 64 mg/L (30.88 %). Two hundred and sixty representative mupirocin-resistant MSSA were analyzed for genes encoding Panton-Valentine leukocidin (PVL, lukS/lukF-PV), exfoliative toxins (eta, etb), adhesin FnbA (fnbA) and resistance genes mupA (high-level resistance to mupirocin), fusB (fusidic acid), aminoglycosides’ modifying enzymes, ermA, ermC and msrA (macrolides/lincosamides) by PCRs. Strains were classified into clones by PFGE and MLST. All mupirocin-resistant MSSA were penicillin-resistant; 92.7 % expressed resistance to fusidic acid and 88.9 % to tobramycin. All 260 molecularly analyzed isolates were mupA-positive; all fusidic acid-resistant (241/260) carried fusB whereas, the tobramycin-resistant ones (230), ant(4′)-Ia. The majority carried eta (93.85 %), etb (98.08 %) and fnbA (88.85 %). PFGE typing revealed a mostly unvarying population; 260 MSSA were grouped into three types. One major eta/etb-positive clone comprising of 258/260 strains (99.2 %), PFGE type 1, was classified as ST121, including nine strains co-carrying PVL. Another PVL-positive strain was identified as ST1, and one toxins-negative as ST21. Conclusions: A mupirocin-resistant MSSA clone, ST121, carrying resistance, exfoliative toxins and adhesin genes, was spread and predominated in SSTIs from patients in Greece during the five-year studied period.Keywords
Funding Information
- University of Patras (39540000)
This publication has 43 references indexed in Scilit:
- Aminoglycoside-resistant staphylococci in Greece: prevalence and resistance mechanismsEuropean Journal of Clinical Microbiology & Infectious Diseases, 2011
- Staphylococcus aureus Host Cell Invasion and Virulence in Sepsis Is Facilitated by the Multiple Repeats within FnBPAPLoS Pathogens, 2010
- Global Distribution and Evolution of Panton‐Valentine Leukocidin–Positive Methicillin‐SusceptibleStaphylococcus aureus,1981–2007The Journal of Infectious Diseases, 2010
- Molecular Types and Genetic Profiles of Staphylococcus aureus Strains Isolated from Bovine Intramammary Infections and Extramammary SitesJournal of Clinical Microbiology, 2008
- Comparison of Molecular Typing Methods for Characterization of Staphylococcus epidermidis : Proposal for Clone DefinitionJournal of Clinical Microbiology, 2008
- Improved Multilocus Sequence Typing Scheme for Staphylococcus epidermidisJournal of Clinical Microbiology, 2007
- Spread of Staphylococcus aureus clinical isolates carrying Panton–Valentine leukocidin genes during a 3-year period in GreeceClinical Microbiology & Infection, 2006
- Analysis of the Genetic Variability of Virulence-Related Loci in Epidemic Clones of Methicillin-Resistant Staphylococcus aureusAntimicrobial Agents and Chemotherapy, 2005
- erm(C) is the predominant genetic determinant for the expression of resistance to macrolides among methicillin-resistant Staphylococcus aureus clinical isolates in GreeceJournal of Antimicrobial Chemotherapy, 2004
- Clonal dissemination of mupirocin-resistant staphylococci in Greek hospitalsJournal of Antimicrobial Chemotherapy, 2003