Epidemiology, evolution and cryptic susceptibility of methicillin-resistant Staphylococcus aureus in China: a whole-genome-based survey

Chen, Yan; Sun, Lu; Ba, Xiaoliang; Jiang, Shengnan; Zhuang, Hemu; Zhu, Feiteng; Wang, Haiping; Lan, Peng; Shi, Qiucheng; Wang, Zhengan; Chen, Yiyi; Shi, Kezhang; Ji, Shujuan; Jiang, Yan; Holmes, Mark A.; Yu, Yunsong

doi:10.1016/j.cmi.2021.05.024

Cited by 41 publications

(37 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, CC59-ST59, CC5-ST5/ST764 and CC8-ST239 were the key lineages responsible for mediating the development of the methicillin resistance in S. aureus in clinical environment in China [ 9 ]. The HA-MRSA CC8-ST239 has been a pandemic linage circulating in many countries worldwide since the 1970s [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Methicillin-resistant Staphylococcus aureus in China: a multicentre longitudinal study and whole-genome sequencing

Wang

Zhao

et al. 2022

Emerging Microbes & Infections

View full text Add to dashboard Cite

The aim of this study was to investigate the genomic epidemiology of MRSA in China to identify predominant lineages and their associated genomic and phenotypic characteristics. In this study, we conducted whole-genome sequencing on 565 MRSA isolates from 7 provinces and municipalities of China between 2014 and 2020. MRSA isolates were subjected to MLST, spa typing, SCC mec typing, analysis of virulence determinants and antimicrobial susceptibility testing. Among 565 MRSA isolates tested, clonal complex (CC) 59 (31.2%), CC5 (23.4%) and CC8 (13.63%) were the major lineages, and the clonal structure was dominated by ST59-t437-IV (14.9%), ST239-t030-III (6.4%) and ST5-t2460-II (6.0%), respectively. Of note, CC8, the predominant lineage in 2014–2015, was replaced by CC59 after 2016. Interestingly, the extension and unstable structure of the CC5 population was observed, with ST5-t311-II, ST764-t1084-II, ST5-t2460-II and ST764-t002-II existing complex competition. Further analysis revealed that virulence determinant profiles and antibiograms were closely associated with the clonal lineage. The CC59 MRSA was less resistant to most tested antimicrobials and carried fewer resistance determinants. But rifampicin resistance and mupirocin resistance were closely linked with CC8 and CC5, respectively. MRSA isolates conservatively carried multiple virulence genes involved in various functions. PVL encoding genes were more common in ST338, CC30, CC398, ST8 and CC22, while tsst -1 was associated with ST5. In conclusion, the community-associated CC59-ST59-t437-IV lineage was predominant in China, with diverse clonal isolates alternately circulating in various geographical locations. Our study highlights the need for MRSA surveillance in China to monitor changes in MRSA epidemiology.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Whole-genome sequencing allows for a comprehensive analysis of the epidemiology and genomic repertoire of S. aureus and provides in-depth insights into the evolution of particular MRSA clones [ 6 , 8 ]. While few studies have characterized extensive collections of MRSA isolates from China using whole-genome sequencing [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Methicillin-resistant Staphylococcus aureus in China: a multicentre longitudinal study and whole-genome sequencing

Wang

Zhao

et al. 2022

Emerging Microbes & Infections

View full text Add to dashboard Cite

show abstract

“…The associated STs shared by six of the seven loci were included into the same CCs (14). CC59, CC7, CC25, CC121, and CC398 were assigned according to previous publications (22,28,29). CC944 was assigned in this study because its associated ST, ST944, was the first reported type to the best of our knowledge.…”

Section: Mlst and Data Analysismentioning

confidence: 99%

“…Moreover, in China, the environmental origins of dominant lineages differed. Recently, ST5 and ST239 were found to be major lineages in hospital settings, whereas ST59 was mainly found in community settings (22). However, it was reported that the ST45 lineage has recently emerged in the community acquiring multiple antimicrobial resistance determinants (23,24).…”

Section: Introductionmentioning

confidence: 99%

Active Surveillance, Drug Resistance, and Genotypic Profiling of Staphylococcus aureus Among School-Age Children in China

Liang

Gao

et al. 2021

Front. Med.

View full text Add to dashboard Cite

Methicillin-susceptible (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization predisposes individuals for endogenous infections and is a major threat to children. Recently, oxacillin/cefoxitin-susceptible mecA-positive S. aureus (OS-MRSA) has been reported worldwide. Herein, a prospective, cross-sectional study was conducted across five schools, representing three educational stages, in Guangzhou, China. Nasal swabs from 2,375 students were cultured for S. aureus and all isolates were subjected to antibiotic susceptibility testing phenotypically and confirmed by femB and mecA genetic detection; all the isolates were classified as MSSA, MRSA, or OS-MRSA. All strains were also analyzed by multi-locus sequence typing. Among the 2,375 swabs, S. aureus was detected in 744 children (31.3%, 95% CI: 25.9–36.7%), of whom 72 had MRSA (3.0%, 95% CI: 0.6–5.4%) and 4 had OS-MRSA (0.2%, 95% CI: 0.1–0.3%), of which an oxacillin- and cefoxitin-susceptible MRSA strain was identified. The prevalence of S. aureus and MRSA was higher in younger children. The highest percentage of drug resistance of the S. aureus isolates (n = 744) was to penicillin (85.5%), followed by erythromycin (43.3%) and clidamycin (41.0%). The most prevalent sequence types (STs) were ST30, ST45, and ST188 in MSSA, accounting for 38.7% of the total isolates, whereas ST45, ST59, and ST338 accounted for 74.6% of the MRSA isolates and ST338 accounted for 50.0% of the OS-MRSA isolates. The MRSA and OS-MRSA isolates (n = 76) were grouped into three clades and one singleton, with clonal complex (CC) 45 as the most predominant linkage. The top nine multi-locus sequence typing-based CCs (CC30, CC45, CC5, CC1, CC15, CC944, CC398, CC59, CC7) represented 86.7% of all S. aureus isolates. All CC30 isolates were resistant to erythromycin and clidamycin, and almost all these isolates were also resistant to penicillin (99.2%). The CC45 and CC59 isolates exhibited high resistance rates to oxacillin at 31.5 and 59.0%, respectively. This study provides updated data valuable for designing effective control strategies to mitigate the burden of disease and to improve the adequacy of empirical antimicrobial treatments for potentially harmful infections.

show abstract

“…However, in the last decade, a blurring of the definition between CA-MRSA and HA-MRSA has been observed. CA-MRSA has gradually gained a foothold in health care settings, and the more susceptible CA-MRSA clones have gradually replaced the multiresistant HA-MRSA lineages in several countries, including China ( 7 – 11 ). This indicates that the epidemiological dynamics of MRSA is associated with the increasing transmission of CA-MRSA strains in health care settings.…”

Section: Introductionmentioning

confidence: 99%

Genomic Epidemiology and Characterization of Methicillin-Resistant Staphylococcus aureus from Bloodstream Infections in China

et al. 2021

View full text Add to dashboard Cite

show abstract

Epidemiology, evolution and cryptic susceptibility of methicillin-resistant Staphylococcus aureus in China: a whole-genome-based survey

Abstract: Epidemiology, evolution and cryptic susceptibility of methicillin-resistant Staphylococcus aureus in China: a whole-genome-based survey,

Cited by 41 publications

References 23 publications

Methicillin-resistant Staphylococcus aureus in China: a multicentre longitudinal study and whole-genome sequencing

Methicillin-resistant Staphylococcus aureus in China: a multicentre longitudinal study and whole-genome sequencing

Active Surveillance, Drug Resistance, and Genotypic Profiling of Staphylococcus aureus Among School-Age Children in China

Genomic Epidemiology and Characterization of Methicillin-Resistant Staphylococcus aureus from Bloodstream Infections in China

Contact Info

Product

Resources

About