Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children
Abstract Objective To investigate the characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) in bone and joint infection (BJI) among children. Methods A total of 338 patients diagnosed with BJI from 2013 to 2022 in Children’s Hospital of Fudan University were enrolled. Demographic inf...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12941-023-00654-3 |
| _version_ | 1797453619959693312 |
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| author | Pan Fu Yaxier Nijiati Tingting Li Xia Wu Zixuan Wang Jinlan Zhou Chuanqing Wang Bo Ning |
| author_facet | Pan Fu Yaxier Nijiati Tingting Li Xia Wu Zixuan Wang Jinlan Zhou Chuanqing Wang Bo Ning |
| author_sort | Pan Fu |
| collection | DOAJ |
| description | Abstract Objective To investigate the characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) in bone and joint infection (BJI) among children. Methods A total of 338 patients diagnosed with BJI from 2013 to 2022 in Children’s Hospital of Fudan University were enrolled. Demographic information, microbiology culture results and laboratory findings, including white blood counts (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR) were collected and analyzed. MRSA was confirmed by antimicrobial susceptibility testing. Other MRSA-caused infections were randomly selected for comparison. Twenty-three virulence and antimicrobial resistance (AMR) genes were screened for MRSA strains. Multilocus sequence typing (MLST) and Staphylococcal protein A (spa) typing were performed using PCR amplification and sequencing. Results Of the identified pathogens in BJI, MRSA accounted for 21.0% (47/224). Patients with BJI had high levels of initial CRP, white blood cell count (WBC) and IL-6. ST59 (43.9%) and t437 (37.6%) were the main MRSA subtypes isolated from the children. The major genotypes in BJI were ST59-t437 (29.8%) and ST22-t309 (14.9%), with high carriage of hemolysins including hla (94.4–100%), hlb (66.2–93.3%), and hld (100%). Notably, Panton–Valentine leukocidin (pvl) had a high prevalence (53.3%) in ST22-t309-MRSA. Other virulence genes including tst, seg and sei were more commonly detected in ST22-t309-MRSA (40.0–46.7%) than in ST59-t437-MRSA (4.2–9.9%). High-carriage AMR genes in MRSA included aph(3ʹ)/III (66.7–80%), ermB (57.5–73.3%) and ermC (66.7–78.9%). MRSA presented high-resistance to erythromycin (52.0–100%) and clindamycin (48.0–92.5%), different genotypes displayed variation in their susceptibilities to antibiotics. Conclusions The major MRSA genotype in BJI was ST59-t437, followed by ST22-t309, with a higher prevalence of the pvl gene. Continuous surveillance of pvl-positive ST22-t309-MRSA in pediatric BJI infections is thus required. |
| first_indexed | 2024-03-09T15:25:27Z |
| format | Article |
| id | doaj.art-9293bc63048746de9673c85c0cbad7f5 |
| institution | Directory Open Access Journal |
| issn | 1476-0711 |
| language | English |
| last_indexed | 2024-03-09T15:25:27Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj.art-9293bc63048746de9673c85c0cbad7f52023-11-26T12:34:46ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112023-11-012211910.1186/s12941-023-00654-3Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among childrenPan Fu0Yaxier Nijiati1Tingting Li2Xia Wu3Zixuan Wang4Jinlan Zhou5Chuanqing Wang6Bo Ning7Department of Clinical Microbiology Laboratory, Children’s Hospital of Fudan University, National Children’s Medical CenterOrthopedics Department, Children’s Hospital of Fudan University, National Children’s Medical CenterDepartment of Clinical Laboratory, Children’s Hospital of Fudan University, National Children’s Medical CenterDepartment of Infectious Diseases, Children’s Hospital of Fudan University, National Children’s Medical CenterDepartment of Infectious Diseases, Children’s Hospital of Fudan University, National Children’s Medical CenterPediatric Intensive Care Unit, Children’s Hospital of Fudan University, National Children’s Medical CenterDepartment of Clinical Microbiology Laboratory, Children’s Hospital of Fudan University, National Children’s Medical CenterOrthopedics Department, Children’s Hospital of Fudan University, National Children’s Medical CenterAbstract Objective To investigate the characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) in bone and joint infection (BJI) among children. Methods A total of 338 patients diagnosed with BJI from 2013 to 2022 in Children’s Hospital of Fudan University were enrolled. Demographic information, microbiology culture results and laboratory findings, including white blood counts (WBC), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and erythrocyte sedimentation rate (ESR) were collected and analyzed. MRSA was confirmed by antimicrobial susceptibility testing. Other MRSA-caused infections were randomly selected for comparison. Twenty-three virulence and antimicrobial resistance (AMR) genes were screened for MRSA strains. Multilocus sequence typing (MLST) and Staphylococcal protein A (spa) typing were performed using PCR amplification and sequencing. Results Of the identified pathogens in BJI, MRSA accounted for 21.0% (47/224). Patients with BJI had high levels of initial CRP, white blood cell count (WBC) and IL-6. ST59 (43.9%) and t437 (37.6%) were the main MRSA subtypes isolated from the children. The major genotypes in BJI were ST59-t437 (29.8%) and ST22-t309 (14.9%), with high carriage of hemolysins including hla (94.4–100%), hlb (66.2–93.3%), and hld (100%). Notably, Panton–Valentine leukocidin (pvl) had a high prevalence (53.3%) in ST22-t309-MRSA. Other virulence genes including tst, seg and sei were more commonly detected in ST22-t309-MRSA (40.0–46.7%) than in ST59-t437-MRSA (4.2–9.9%). High-carriage AMR genes in MRSA included aph(3ʹ)/III (66.7–80%), ermB (57.5–73.3%) and ermC (66.7–78.9%). MRSA presented high-resistance to erythromycin (52.0–100%) and clindamycin (48.0–92.5%), different genotypes displayed variation in their susceptibilities to antibiotics. Conclusions The major MRSA genotype in BJI was ST59-t437, followed by ST22-t309, with a higher prevalence of the pvl gene. Continuous surveillance of pvl-positive ST22-t309-MRSA in pediatric BJI infections is thus required.https://doi.org/10.1186/s12941-023-00654-3Methicillin-resistant Staphylococcus aureusBone and joint infectionPanton–Valentine leukocidinVirulenceChildren |
| spellingShingle | Pan Fu Yaxier Nijiati Tingting Li Xia Wu Zixuan Wang Jinlan Zhou Chuanqing Wang Bo Ning Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children Annals of Clinical Microbiology and Antimicrobials Methicillin-resistant Staphylococcus aureus Bone and joint infection Panton–Valentine leukocidin Virulence Children |
| title | Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children |
| title_full | Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children |
| title_fullStr | Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children |
| title_full_unstemmed | Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children |
| title_short | Clinical and molecular characteristics of methicillin-resistant Staphylococcus aureus in bone and joint infection among children |
| title_sort | clinical and molecular characteristics of methicillin resistant staphylococcus aureus in bone and joint infection among children |
| topic | Methicillin-resistant Staphylococcus aureus Bone and joint infection Panton–Valentine leukocidin Virulence Children |
| url | https://doi.org/10.1186/s12941-023-00654-3 |
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