A Prospective Cohort Multicenter Study of Molecular Epidemiology and Phylogenonnics of Staphylococcus aureus Bacterennia in Nine Latin American Countries
A Prospective Cohort Multicenter Study of Molecular Epidemiology and Phylogenonnics of Staphylococcus aureus Bacterennia in Nine Latin American Countries
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DOI：
10.1128/aac.00816-17
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发表时间：
2017-10-01
影响因子：
4.9
通讯作者：
Seas, Carlos
中科院分区：
文献类型：
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作者：
Arias, Cesar A.;Reyes, Jinnethe;Seas, Carlos
金黄色葡萄球菌是一种重要的病原体，可引起一系列疾病，从轻度皮肤和软组织感染到危及生命的疾病。血液感染尤其重要，耐甲氧西林沙门氏菌的存在使治疗方法变得复杂。金黄色葡萄球菌（MRSA）分离株。随着社区相关USA 300拉丁美洲变体（USA 300-LV）的兴起和传播，MRSA新遗传谱系的出现发生在拉丁美洲（LA）。在这里，我们前瞻性地描述了从9个拉丁美洲国家的选定医院回收的血流MRSA。所有分离株进行了分型脉冲场凝胶电泳（PFGE），并进行抗生素敏感性试验。对96例MRSA代表进行全基因组测序。MRSA占所有病例的45%（1，185 S。金黄色葡萄球菌）分离株。大多数MRSA分离株属于克隆簇（CC）5。在哥伦比亚和厄瓜多尔，大多数分离株（72%）属于USA 300-LV谱系（CC 8）。系统发育重建表明，MRSA菌株从参与医院属于三个主要分支。进化枝A将具有序列类型5（ST 5）、ST 105和ST 1011的分离物分组（主要是葡萄球菌染色体盒mec [SCCmed I和II）。进化枝B包括ST 8、5 T88、ST 97和ST 72菌株（SCCmec IV，亚型a、B和c/E），而进化枝C主要将阿根廷MRSA分组，属于ST 30。总之，CC 5 MRSA在洛杉矶的血流感染中普遍存在，但哥伦比亚和厄瓜多尔除外，其中USA 300-LV现在是优势谱系。克隆替换似乎是一种常见现象，持续监测对于确定MRSA分子流行病学的变化至关重要。
Staphylococcus aureus is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant S. aureus (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 S. aureus) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette mec [SCCmed I and II). Clade B included ST8, 5T88, ST97, and ST72 strains (SCCmec IV, subtypes a, b, and c/E), and dade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA.