Changes in genetic lineages, resistance, and virulence in clinical methicillin-resistant Staphylococcus aureus in a Span
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ORIGINAL ARTICLE
Changes in genetic lineages, resistance, and virulence in clinical methicillin-resistant Staphylococcus aureus in a Spanish hospital Carmen Lozano • Nerea Porres-Osante • Julien Crettaz Beatriz Rojo-Bezares • Daniel Benito • Ine´s Olarte • Myriam Zarazaga • Yolanda Sa´enz • Carmen Torres
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Received: 26 July 2012 / Accepted: 13 September 2012 / Published online: 3 October 2012 Ó Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases 2012
Abstract A total of 204 methicillin-resistant Staphylococcus aureus (MRSA) isolates were isolated in a Spanish hospital in two different periods (2001 and 2009). The percentages of MRSA isolates detected in 2001 and 2009 were 29 and 27 %, respectively. Genetic lineages, resistance mechanisms, and virulence traits were determined in these isolates. The most frequent detected lineage in both periods was S. aureus protein A (spa)-type t067, assigned to clonal complex (CC) 5 (CC5-t067), being more prevalent in 2001 (93 %) than in 2009 (71 %). The remaining CCs and spa-types detected were (%2001/%2009): CC5t002 (0/5), CC8-t008 (1/16), CC8-t024 (0/1), CC8-t190 (0/3), CC8-t2849 (0/2), CC22-t032 (0/2), CC30-t012 (1/0), CC228-t109 (1/0), CC228-t1318 (2/0), and CC247-t051 (2/0). Most of the MRSA were isolated from wounds, representing 39 % in 2001 and 63 % in 2009. The emergence of MRSA CC8 isolates, mainly from wounds, seemed to occur in the second period. Resistance to (%2001/%2009) quinolones (99/87), aminoglycosides (98/ 88), macrolides (32/30), lincosamides (30/17), and tetracycline (2/1) was found in isolates in both periods. Trimethoprim-sulfamethoxazole resistance was detected only in 2001 (1 %), and chloramphenicol (1 %) and mupirocin C. Lozano N. Porres-Osante D. Benito M. Zarazaga C. Torres (&) Biochemistry and Molecular Biology, University of La Rioja, Madre de Dios 51, 26006 Logron˜o, Spain e-mail: [email protected] N. Porres-Osante B. Rojo-Bezares Y. Sa´enz C. Torres Molecular Microbiology Area, Center of Biomedical Research of La Rioja (CIBIR), Logron˜o, Spain J. Crettaz I. Olarte Laboratory of Microbiology, Hospital San Pedro, Logron˜o, Spain
resistance (11 %) were detected only in 2009. An association between staphylococcal enterotoxin gene profiles and CCs was detected in most of the cases. The egc-cluster was related to CC5, CC22, CC30, and CC228 and most of the CC8 isolates presented the sed, sej, and ser genes. Four tst1-positive (CC5 and CC30) isolates were detected in 2001 and two lukS/F-PV-positive isolates were detected in 2009. Therefore, there is still a predominance of CC5-t067 in our region, although an increase of lineage CC8 was observed. Keywords MRSA Spanish hospital CC5-t067 CC8 PVL TSST
Introduction Staphylococcus aureus is an important pathogen which is able to develop resistance to multiple antimicrobial agents. This microorganism produces large amounts of virulence factors, and some of them can be classified as leukocidins [as Panton-Valentine leukocidin (PVL)], pyrogenic
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