Livestock-associated methicillin-resistant Staphylococcus aureus epidemiology, genetic diversity, and clinical characteristics in an urban region.

Autor:	Konstantinovski MM; Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands.; Department of Microbiology, Medical Laboratories, Reinier de Graaf Groep, Delft, Netherlands., Schouls LM; Center for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands., Witteveen S; Center for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands., Claas ECJ; Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands., Kraakman ME; Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands., Kalpoe J; Department of Medical Microbiology, Regional Laboratory of Public Health Kennemerland, Haarlem, Netherlands., Mattson E; Department of Microbiology, Medical Laboratories, Reinier de Graaf Groep, Delft, Netherlands., Hetem DJ; Department of Medical Microbiology, Haaglanden Medical Center, The Hague, Netherlands., van Elzakker EPM; Laboratory of Medical Microbiology, HagaZiekenhuis, The Hague, Netherlands., Kerremans J; Department of Medical Microbiology, Alrijne Hospital, Leiderdorp, Netherlands., Hira V; Department of Medical Microbiology and Infection Prevention, Groene Hart Ziekenhuis, Gouda, Netherlands., Bosch T; Center for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands., Gooskens J; Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands.
Jazyk:	angličtina
Zdroj:	Frontiers in microbiology [Front Microbiol] 2022 Dec 14; Vol. 13, pp. 875775. Date of Electronic Publication: 2022 Dec 14 (Print Publication: 2022).
DOI:	10.3389/fmicb.2022.875775
Abstrakt:	Objectives: While Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA), defined as CC398, is a well-known pathogen among those working with livestock, there are indications that LA-MRSA prevalence among the general population is increasing. However, the clinical impact in urban areas remains unknown. The aim of this study was to assess the genetic epidemiology and clinical characteristics of LA-MRSA in an urban area with a limited livestock population. Methods: In this retrospective study, we evaluated LA-MRSA strains that were collected between 2014 and 2018 from patients who received clinical care in a single urban area in Netherlands. Patient files were assessed for livestock exposure data, clinical findings, and contact tracing information. Next-generation sequencing (NGS) analysis in combination with wgMLST was conducted to assess genetic diversity and relatedness and to detect virulence and resistance genes. Results: LA-MRSA strains were cultured from 81 patients, comprising 12% of all the MRSA strains found in seven study laboratories between 2014 and 2018. No livestock link was found in 76% of patients ( n = 61), and 28% of patients ( n = 23) had an infection, mostly of the skin or soft tissue. Contact tracing had been initiated in 14 cases, leading to the identification of two hospital transmissions: a cluster of 9 cases and one of 2 cases. NGS data were available for 91% ( n = 75) of the patients. wgMLST confirmed the clusters detected via contact tracing ( n = 2) and identified 5 additional clusters without a known epidemiological link. Relevant resistance and virulence findings included the PVL virulence gene (3 isolates) and tetracycline resistance (79 isolates). Conclusion: LA-MRSA may cause a relevant burden of disease in urban areas. Surprisingly, most infections in the present study occurred in the absence of a livestock link, suggesting inter-human transmission. These findings and the presence of PVL and other immune evasive complex virulence genes warrant future surveillance and preventative measures. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Konstantinovski, Schouls, Witteveen, Claas, Kraakman, Kalpoe, Mattson, Hetem, van Elzakker, Kerremans, Hira, Bosch and Gooskens.)
Databáze:	MEDLINE
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