Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China

<br><strong>Background<br></strong> Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen subdivided into lineages termed sequence types (STs). Since the 1950s, successive waves of STs have appeared and replaced previously dominant lineages. One su...

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Main Authors: Chen, H, Yin, Y, van Dorp, L, Shaw, LP, Gao, H, Acman, M, Yuan, J, Chen, F, Sun, S, Wang, X, Li, S, Zhang, Y, Farrer, RA, Wang, H, Balloux, F
Format: Journal article
Language:English
Published: BioMed Central 2021
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author Chen, H
Yin, Y
van Dorp, L
Shaw, LP
Gao, H
Acman, M
Yuan, J
Chen, F
Sun, S
Wang, X
Li, S
Zhang, Y
Farrer, RA
Wang, H
Balloux, F
author_facet Chen, H
Yin, Y
van Dorp, L
Shaw, LP
Gao, H
Acman, M
Yuan, J
Chen, F
Sun, S
Wang, X
Li, S
Zhang, Y
Farrer, RA
Wang, H
Balloux, F
author_sort Chen, H
collection OXFORD
description <br><strong>Background<br></strong> Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen subdivided into lineages termed sequence types (STs). Since the 1950s, successive waves of STs have appeared and replaced previously dominant lineages. One such event has been occurring in China since 2013, with community-associated (CA-MRSA) strains including ST59 largely replacing the previously dominant healthcare-associated (HA-MRSA) ST239. We previously showed that ST59 isolates tend to have a competitive advantage in growth experiments against ST239. However, the underlying genomic and phenotypic drivers of this replacement event are unclear. <br><strong> Methods<br></strong> Here, we investigated the replacement of ST239 using whole-genome sequencing data from 204 ST239 and ST59 isolates collected in Chinese hospitals between 1994 and 2016. We reconstructed the evolutionary history of each ST and considered two non-mutually exclusive hypotheses for ST59 replacing ST239: antimicrobial resistance (AMR) profile and/or ability to colonise and persist in the environment through biofilm formation. We also investigated the differences in cytolytic activity, linked to higher virulence, between STs. We performed an association study using the presence and absence of accessory virulence genes. <br><strong> Results<br></strong> ST59 isolates carried fewer AMR genes than ST239 and showed no evidence of evolving towards higher AMR. Biofilm production was marginally higher in ST59 overall, though this effect was not consistent across sub-lineages so is unlikely to be a sole driver of replacement. Consistent with previous observations of higher virulence in CA-MRSA STs, we observed that ST59 isolates exhibit significantly higher cytolytic activity than ST239 isolates, despite carrying on average fewer putative virulence genes. Our association study identified the chemotaxis inhibitory protein (chp) as a strong candidate for involvement in the increased virulence potential of ST59. We experimentally validated the role of chp in increasing the virulence potential of ST59 by creating Δchp knockout mutants, confirming that ST59 can carry chp without a measurable impact on fitness. <br><strong> Conclusions<br></strong> Our results suggest that the ongoing replacement of ST239 by ST59 in China is not associated to higher AMR carriage or biofilm production. However, the increase in ST59 prevalence is concerning since it is linked to a higher potential for virulence, aided by the carriage of the chp gene.
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spelling oxford-uuid:9f98dd0a-3559-4500-8caa-dccb12f6973e2022-03-27T00:59:15ZDrivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in ChinaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9f98dd0a-3559-4500-8caa-dccb12f6973eEnglishSymplectic ElementsBioMed Central2021Chen, HYin, Yvan Dorp, LShaw, LPGao, HAcman, MYuan, JChen, FSun, SWang, XLi, SZhang, YFarrer, RAWang, HBalloux, F<br><strong>Background<br></strong> Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen subdivided into lineages termed sequence types (STs). Since the 1950s, successive waves of STs have appeared and replaced previously dominant lineages. One such event has been occurring in China since 2013, with community-associated (CA-MRSA) strains including ST59 largely replacing the previously dominant healthcare-associated (HA-MRSA) ST239. We previously showed that ST59 isolates tend to have a competitive advantage in growth experiments against ST239. However, the underlying genomic and phenotypic drivers of this replacement event are unclear. <br><strong> Methods<br></strong> Here, we investigated the replacement of ST239 using whole-genome sequencing data from 204 ST239 and ST59 isolates collected in Chinese hospitals between 1994 and 2016. We reconstructed the evolutionary history of each ST and considered two non-mutually exclusive hypotheses for ST59 replacing ST239: antimicrobial resistance (AMR) profile and/or ability to colonise and persist in the environment through biofilm formation. We also investigated the differences in cytolytic activity, linked to higher virulence, between STs. We performed an association study using the presence and absence of accessory virulence genes. <br><strong> Results<br></strong> ST59 isolates carried fewer AMR genes than ST239 and showed no evidence of evolving towards higher AMR. Biofilm production was marginally higher in ST59 overall, though this effect was not consistent across sub-lineages so is unlikely to be a sole driver of replacement. Consistent with previous observations of higher virulence in CA-MRSA STs, we observed that ST59 isolates exhibit significantly higher cytolytic activity than ST239 isolates, despite carrying on average fewer putative virulence genes. Our association study identified the chemotaxis inhibitory protein (chp) as a strong candidate for involvement in the increased virulence potential of ST59. We experimentally validated the role of chp in increasing the virulence potential of ST59 by creating Δchp knockout mutants, confirming that ST59 can carry chp without a measurable impact on fitness. <br><strong> Conclusions<br></strong> Our results suggest that the ongoing replacement of ST239 by ST59 in China is not associated to higher AMR carriage or biofilm production. However, the increase in ST59 prevalence is concerning since it is linked to a higher potential for virulence, aided by the carriage of the chp gene.
spellingShingle Chen, H
Yin, Y
van Dorp, L
Shaw, LP
Gao, H
Acman, M
Yuan, J
Chen, F
Sun, S
Wang, X
Li, S
Zhang, Y
Farrer, RA
Wang, H
Balloux, F
Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title_full Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title_fullStr Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title_full_unstemmed Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title_short Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China
title_sort drivers of methicillin resistant staphylococcus aureus mrsa lineage replacement in china
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