Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections
Abstract Background Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCCmecII lineage replaced the previously well-established clones. However, the emergence of community-associated (...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-09-01
|
| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13756-022-01154-3 |
| _version_ | 1797995448657510400 |
|---|---|
| author | Mariana Fernandes Augusto Débora Cristina da Silva Fernandes Tamara Lopes Rocha de Oliveira Fernanda Sampaio Cavalcante Raiane Cardoso Chamon Adriana Lúcia Pires Ferreira Simone Aranha Nouér Infection Control Group HUCFF/UFRJ Kátia Regina Netto dos Santos |
| author_facet | Mariana Fernandes Augusto Débora Cristina da Silva Fernandes Tamara Lopes Rocha de Oliveira Fernanda Sampaio Cavalcante Raiane Cardoso Chamon Adriana Lúcia Pires Ferreira Simone Aranha Nouér Infection Control Group HUCFF/UFRJ Kátia Regina Netto dos Santos |
| author_sort | Mariana Fernandes Augusto |
| collection | DOAJ |
| description | Abstract Background Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCCmecII lineage replaced the previously well-established clones. However, the emergence of community-associated (CA) MRSA lineages among hospitalized patients is an increasing issue. Methods Consecutive S. aureus isolates recovered from BSI episodes of patients admitted between January 2016 and December 2018 in a Brazilian teaching hospital were tested for antimicrobial resistance, their genotypic features were characterized, and the clinical characteristics of the patients were evaluated. Results A total of 123 S. aureus isolates were recovered from 113 patients. All isolates were susceptible to linezolid, teicoplanin and vancomycin and 13.8% were not susceptible to daptomycin. Vancomycin MIC50 and MIC90 of 2 mg/L were found for both MRSA and MSSA isolates. The MRSA isolation rate was 30.1% (37/123), and 51.4% of them carried the SCCmec type II, followed by SCCmecIV (40.5%). Among the 37 MRSA isolates, the main lineages found were USA100/SCCmecII/ST5 and ST105 (53.7%) and USA800/ST5/SCCmecIV (18.9%). Surprisingly, six (16%) CA-MRSA isolates, belonging to USA300/ST8/SCCmecIVa that carried PVL genes and the ACME cassette type I, were detected. These six patients with USA300 BSI had severe comorbidities, including cancer, and most had a Charlson score ≥ 5; furthermore, they were in wards attended by the same health professionals. MRSA isolates were associated with hospital acquired infections (p = 0.02) in more elderly patients (p = 0.03) and those diagnosed with hematologic cancer (p = 0.04). Among patients diagnosed with MRSA BSI, 19 (54.3%) died. Conclusions The pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates. |
| first_indexed | 2024-04-11T10:01:43Z |
| format | Article |
| id | doaj.art-5a228b006d7c4ef2b33def597dbe033e |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-04-11T10:01:43Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-5a228b006d7c4ef2b33def597dbe033e2022-12-22T04:30:24ZengBMCAntimicrobial Resistance and Infection Control2047-29942022-09-0111111010.1186/s13756-022-01154-3Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infectionsMariana Fernandes Augusto0Débora Cristina da Silva Fernandes1Tamara Lopes Rocha de Oliveira2Fernanda Sampaio Cavalcante3Raiane Cardoso Chamon4Adriana Lúcia Pires Ferreira5Simone Aranha Nouér6Infection Control Group HUCFF/UFRJKátia Regina Netto dos Santos7Laboratório de Infecção Hospitalar, Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de JaneiroDepartamento de Microbiologia, Imunologia e Parasitologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de JaneiroLaboratório de Infecção Hospitalar, Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de JaneiroCentro Multidisciplinar de Macaé, Universidade Federal do Rio de JaneiroDepartamento de Patologia, Faculdade de Medicina, Universidade Federal FluminenseServiço de Patologia Clínica, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de JaneiroFaculdade de Medicina, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de JaneiroLaboratório de Infecção Hospitalar, Departamento de Microbiologia Médica, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de JaneiroAbstract Background Staphylococcus aureus is one of the leading causes of bloodstream infections (BSI) worldwide. In Brazil, the hospital-acquired methicillin-resistant S. aureus USA100/SCCmecII lineage replaced the previously well-established clones. However, the emergence of community-associated (CA) MRSA lineages among hospitalized patients is an increasing issue. Methods Consecutive S. aureus isolates recovered from BSI episodes of patients admitted between January 2016 and December 2018 in a Brazilian teaching hospital were tested for antimicrobial resistance, their genotypic features were characterized, and the clinical characteristics of the patients were evaluated. Results A total of 123 S. aureus isolates were recovered from 113 patients. All isolates were susceptible to linezolid, teicoplanin and vancomycin and 13.8% were not susceptible to daptomycin. Vancomycin MIC50 and MIC90 of 2 mg/L were found for both MRSA and MSSA isolates. The MRSA isolation rate was 30.1% (37/123), and 51.4% of them carried the SCCmec type II, followed by SCCmecIV (40.5%). Among the 37 MRSA isolates, the main lineages found were USA100/SCCmecII/ST5 and ST105 (53.7%) and USA800/ST5/SCCmecIV (18.9%). Surprisingly, six (16%) CA-MRSA isolates, belonging to USA300/ST8/SCCmecIVa that carried PVL genes and the ACME cassette type I, were detected. These six patients with USA300 BSI had severe comorbidities, including cancer, and most had a Charlson score ≥ 5; furthermore, they were in wards attended by the same health professionals. MRSA isolates were associated with hospital acquired infections (p = 0.02) in more elderly patients (p = 0.03) and those diagnosed with hematologic cancer (p = 0.04). Among patients diagnosed with MRSA BSI, 19 (54.3%) died. Conclusions The pandemic MRSA USA300 was detected for the first time in the Brazilian teaching hospital under study, and its cross-transmission most probably occurred between patients with BSI. This lineage may already be circulating among other Brazilian hospitals, which highlights the importance of carrying out surveillance programs to fight multidrug resistant and hypervirulent isolates.https://doi.org/10.1186/s13756-022-01154-3S. aureusBloodstream infectionsMRSAUSA300USA100PVL genes |
| spellingShingle | Mariana Fernandes Augusto Débora Cristina da Silva Fernandes Tamara Lopes Rocha de Oliveira Fernanda Sampaio Cavalcante Raiane Cardoso Chamon Adriana Lúcia Pires Ferreira Simone Aranha Nouér Infection Control Group HUCFF/UFRJ Kátia Regina Netto dos Santos Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections Antimicrobial Resistance and Infection Control S. aureus Bloodstream infections MRSA USA300 USA100 PVL genes |
| title | Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections |
| title_full | Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections |
| title_fullStr | Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections |
| title_full_unstemmed | Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections |
| title_short | Pandemic clone USA300 in a Brazilian hospital: detection of an emergent lineage among methicillin-resistant Staphylococcus aureus isolates from bloodstream infections |
| title_sort | pandemic clone usa300 in a brazilian hospital detection of an emergent lineage among methicillin resistant staphylococcus aureus isolates from bloodstream infections |
| topic | S. aureus Bloodstream infections MRSA USA300 USA100 PVL genes |
| url | https://doi.org/10.1186/s13756-022-01154-3 |
| work_keys_str_mv | AT marianafernandesaugusto pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT deboracristinadasilvafernandes pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT tamaralopesrochadeoliveira pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT fernandasampaiocavalcante pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT raianecardosochamon pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT adrianaluciapiresferreira pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT simonearanhanouer pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT infectioncontrolgrouphucffufrj pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections AT katiareginanettodossantos pandemiccloneusa300inabrazilianhospitaldetectionofanemergentlineageamongmethicillinresistantstaphylococcusaureusisolatesfrombloodstreaminfections |