Molecular epidemiology of Staphylococcus aureus bacteremia in a single large Minnesota medical center in 2015 as assessed using MLST, core genome MLST and spa typing.
Molecular epidemiology of Staphylococcus aureus bacteremia in a single large Minnesota medical center in 2015 as assessed using MLST, core genome MLST and spa typing.
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DOI：
10.1371/journal.pone.0179003
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Patel R
中科院分区：
文献类型：
--
作者：
Park KH;Greenwood-Quaintance KE;Uhl JR;Cunningham SA;Chia N;Jeraldo PR;Sampathkumar P;Nelson H;Patel R
金黄色葡萄球菌是住院患者菌血症的主要原因。然而，金黄色葡萄球菌菌血症（SAB）是否与克隆性相关（是否涉及潜在的医院传播）尚未得到研究。在此，我们使用全基因组测序 (WGS) 检查了 SAB 的流行病学。对 2015 年在明尼苏达州一家大型医疗中心收集的 152 株 SAB 分离株进行了研究。通过 PCR/Sanger 测序进行葡萄球菌蛋白 A (spa) 分型；通过全基因组测序确定多位点序列分型（MLST）和核心基因组MLST（cgMLST）。 48 株分离株 (32%) 为耐甲氧西林金黄色葡萄球菌 (MRSA)。这些分离株包含 66 个 spa 类型，分为 11 个 spa 克隆复合体 (CC) 和 10 个单一类型。 48 个 MRSA 分离株中的 88% 属于 spa CC-002 或 -008。甲氧西林敏感金黄色葡萄球菌 (MSSA) 分离株基因型更加多样化，其中 61% 分布在四个 spa CC（CC-002、CC-012、CC-008 和 CC-084）中。通过MLST，共有31种序列类型（ST），其中18种分为6个CC和13个单ST。在 MSSA 分离株中，常见的 MLST 克隆是 CC5 (23%)、CC30 (19%)、CC8 (15%) 和 CC15 (11%)。常见的MRSA克隆是CC5（67%）和CC8（25%）； CC45 或 CC30 中没有分离出 MRSA。通过cgMLST分析，两个分离株之间存在9个等位基因差异，其余150个分离株之间有40多个等位基因差异。通过病历审查，对这两种分离株进行了流行病学追溯联系。总体而言，cgMLST 分析比多位点序列或 spa 分型产生更高分辨率的流行病学分型。
Staphylococcus aureus is a leading cause of bacteremia in hospitalized patients. Whether or not S. aureus bacteremia (SAB) is associated with clonality, implicating potential nosocomial transmission, has not, however, been investigated. Herein, we examined the epidemiology of SAB using whole genome sequencing (WGS). 152 SAB isolates collected over the course of 2015 at a single large Minnesota medical center were studied. Staphylococcus protein A (spa) typing was performed by PCR/Sanger sequencing; multilocus sequence typing (MLST) and core genome MLST (cgMLST) were determined by WGS. Forty-eight isolates (32%) were methicillin–resistant S. aureus (MRSA). The isolates encompassed 66 spa types, clustered into 11 spa clonal complexes (CCs) and 10 singleton types. 88% of 48 MRSA isolates belonged to spa CC-002 or -008. Methicillin-susceptible S. aureus (MSSA) isolates were more genotypically diverse, with 61% distributed across four spa CCs (CC-002, CC-012, CC-008 and CC-084). By MLST, there was 31 sequence types (STs), including 18 divided into 6 CCs and 13 singleton STs. Amongst MSSA isolates, the common MLST clones were CC5 (23%), CC30 (19%), CC8 (15%) and CC15 (11%). Common MRSA clones were CC5 (67%) and CC8 (25%); there were no MRSA isolates in CC45 or CC30. By cgMLST analysis, there were 9 allelic differences between two isolates, with the remaining 150 isolates differing from each other by over 40 alleles. The two isolates were retroactively epidemiologically linked by medical record review. Overall, cgMLST analysis resulted in higher resolution epidemiological typing than did multilocus sequence or spa typing.