Existence of multiple SCCmec elements in clinical isolates of methicillin-resistant Staphylococcus aureus

Nagasundaram, N.; Sistla, Sujatha

doi:10.1099/jmm.0.000977

Cited by 18 publications

(15 citation statements)

References 30 publications

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“…The presence of unusual SCCmec types in ST22 MRSA indicates an evolutionary genetic change and so demands deeper genomic investigation. Studies have demonstrated the existence of multiple SCCmec types in MRSA [22][23][24]. In the present study, 6% of isolates had multiple SCCmec types.…”

Section: Discussionsupporting

confidence: 47%

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India

Bakthavatchalam

Vasudevan

Rao

et al. 2021

Preprint

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BackgroundSignificant changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) were recognised with the emergence of community-associated methicillin-resistant Staphylococcus aureus. However, studies on the molecular epidemiology and the genomic investigation of MRSA are limited in India. The aim of the study was to understand the molecular epidemiology of MRSA causing bloodstream infection and also to investigate the origin and evolution of ST772 S. aureus isolated from India.ResultsSCCmec V (42%) was the predominant gene followed by SCCmec III (27%), SCCmec IV (13%), SCCmec I (7%) and SCCmec II (3%). We demonstrate the presence of multiple SCCmec types in 18 isolates. MLST analysis revealed ten different clonal complexes and three singletons. ST772 (27%), ST22 (19%) and ST239 (16%) were the predominant MRSA genotypes in causing bloodstream infection. The spa types were highly diverse. Phylogenetic analysis revealed that nearly three-fourth of the Indian STT72-SCCmec V isolates belongs to dominant (ST772-A2) and emerging subgroups (ST772-A3). A prophage Φ IND772 carrying PVL toxin and a staphylococcal enterotoxin A was noticed in all isolates, except two. In addition, three distinct genomic islands (vSa-alpha, beta and gamma) were universally seen in all ST772 S. aureus genomes. A pattern of increasing antimicrobial resistance was noticed in the dominant and emerging subgroups. An integrated resistance plasmid encoding resistance clusters for beta-lactam (blaZ), macrolides (mphC, msrA), and aminoglycoside resistance (aphA-III, sat-4, aadE) was identified in all isolates, except four basal strains. ST772-SCCmec V was emerged on the Indian subcontinent in 1964 and diverged into a dominant subgroup in 1991. Furthermore, the expansion is likely to be associated with the acqusition of mobile genetic elements such as integrated resistance plasmid and SCCmec V (5C2) as well as the fixation of double serine mutation (S84L, S80Y) in the quinolone resistance determining region. ConclusionsST772-SCCmec V has the multi-drug resistance trait of hospital-associated (HA) MRSA and the epidemiological characteristics of CA-MRSA. ST772 S. aureus have consistent virulence and resistance determinants which may results in successful survival in both community and hospital settings.

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Section: Discussionsupporting

confidence: 47%

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India

Bakthavatchalam

Vasudevan

Rao

et al. 2021

Preprint

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“…Studies have demonstrated the existence of multiple SCCmec types in MRSA. [69][70][71] In the present study, 6% of the isolates had multiple SCCmec types. This suggests that multiple transfer events of SCCmec types would resulted in the integration of multiple ccr gene complexes in S. aureus.…”

Section: Discussionmentioning

confidence: 50%

Origin and evolutionary dynamics of multi-drug resistant and highly virulent community-associated methicillin-resistantStaphylococcus aureusST772-SCCmecV lineage

Bakthavatchalam

Vasudevan

Rao

et al. 2020

Preprint

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Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasing in prevalence across the world. However, studies on the molecular epidemiology and the genomic investigation of MRSA are limited in India. Objectives: To understand the molecular epidemiology of MRSA and to reconstruct the origin and evolution of S. aureus belonged to the sequence type (ST772). Methods: A total of 233 non-repetitive MRSA isolates were screened for the presence staphylococcal cassette chromosome (SCCmec) types, multi-locus sequence types (MLST) and staphylococcal protein A (spa) types. Whole genome sequence data of ST772-SCCmec V (n=32) isolates were generated and analysed along with the publically available ST772-SCCmec V (n=273) genome. Results: ST772 (27%), ST22 (19%) and ST239 (16%) were found as the predominant STs. Analysis of the core SNPs using Bayesian time scaled phylogenetic analysis showed ST772-SCCmec V was emerged on the Indian subcontinent in 1960s. The acquisition of integrated resistance plasmid (IRP) in the ST772-SCCmec V lineage during 1990s, fixation of SCCmec V (5C2) and the double serine mutations (S84L, S80Y) appears to have played a key role in the successful expansion. The IRP carries the loci for multiple antibiotic resistant genes: beta-lactam (blaZ), aminoglycosides (aphA3-sat-aadE), macrolide (mphC), macrolide-lincosamide-streptogramin B (msrA) and bacitracin (bacA, bacB). Conclusions: The Panton Valentine Leukocidin (PVL) positive ST772 and ST22 MRSA lineages are observed in the hospital settings. ST772-SCCmec V has the multi-drug resistance trait of hospital-associated (HA) MRSA and the epidemiological characteristics of CA-MRSA. The antimicrobial use pattern may have driven the spread and survival of ST772 MRSA in hospitals.

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“…Clinical MRSA strains carrying two to three different types of SCCmec have been previously reported (Nagasundaram and Sistla, 2019). SCCmec types I through V are frequently identified by multiplex PCR, which has been considered a good tool (Nagasundaram and Sistla, 2019). In this study, were amplified three types of SCCmec (I, II, and III) in three MRSA strains; however, due to the high variability of SCCmec types a sequencing analysis of the amplified products confirmed the presence of the different types of SCCmec (Lakhundi and Zhang, 2018;Nagasundaram and Sistla, 2019).…”

Section: Discussionmentioning

confidence: 56%

“…Composite strains with different SCCmec elements from MRSA and Staphylococcus pseudintermedius were described in Japan (Descloux et al, 2008;Ishihara et al, 2010;Youn et al, 2011). Clinical MRSA strains carrying two to three different types of SCCmec have been previously reported (Nagasundaram and Sistla, 2019). SCCmec types I through V are frequently identified by multiplex PCR, which has been considered a good tool (Nagasundaram and Sistla, 2019).…”

Section: Discussionmentioning

confidence: 99%

Control of Methicillin-Resistant Staphylococcus aureus Strains Associated With a Hospital Outbreak Involving Contamination From Anesthesia Equipment Using UV-C

et al. 2020

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Methicillin-resistant Staphylococcus aureus (MRSA) is considered an opportunistic pathogen in humans and is mainly associated with healthcare-associated infections (HCAIs). This bacterium colonizes the skin and mucous membranes of healthy people and causes frequent hospital outbreaks. The aim of this study was to perform molecular typing of the staphylococcal cassette chromosome mec (SCCmec) and agr loci as wells as to establish the pulsotypes and clonal complexes (CCs) for MRSA and methicillin-sensitive S. aureus (MSSA) outbreaks associated with the operating room (OR) at a pediatric hospital. Twenty-five clinical strains of S. aureus (19 MRSA and 6 MSSA strains) were recovered from the outbreak (patients, anesthesia equipment, and nasopharyngeal exudates from external service anesthesia technicians). These clinical S. aureus strains were mainly resistant to benzylpenicillin (100%) and erythromycin (84%) and were susceptible to vancomycin and nitrofurantoin. The SCCmec type II was amplified in 84% of the S. aureus strains, and the most frequent type of the agr locus was agrII, which was amplified in 72% of the strains; however, the agrI and agrIII genes were mainly detected in MSSA strains. A pulsed-field gel electrophoresis (PFGE) analysis grouped the 25 strains into 16 pulsotypes (P), the most frequent of which was P1, including 10 MRSA strains related to the anesthesia equipment, external service anesthesia technicians, and hospitalized patients. Multilocus sequence typing (MLST) identified 15 sequence types (STs) distributed in nine CCs. The most prevalent ST was ST1011, belonging to CC5, which was associated with the SCCmec type II and agrII type. We postulate that the external service anesthesia technicians were MRSA carriers and that these strains were indirectly transmitted from the contaminated anesthesia equipment that was inappropriately disinfected. Finally, the MRSA outbreak was controlled when the anesthesia equipment disinfection was improved and hand hygiene was reinforced.

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Existence of multiple SCCmec elements in clinical isolates of methicillin-resistant Staphylococcus aureus

Cited by 18 publications

References 30 publications

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India

Origin and evolutionary dynamics of multi-drug resistant and highly virulent community-associated methicillin-resistantStaphylococcus aureusST772-SCCmecV lineage

Control of Methicillin-Resistant Staphylococcus aureus Strains Associated With a Hospital Outbreak Involving Contamination From Anesthesia Equipment Using UV-C

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Existence of multiple SCCmec elements in clinical isolates of methicillin-resistant Staphylococcus aureus

Cited by 18 publications

References 30 publications

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V&nbsp;Lineage From India

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V&nbsp;Lineage From India

Origin and evolutionary dynamics of multi-drug resistant and highly virulent community-associated methicillin-resistantStaphylococcus aureusST772-SCCmecV lineage

Control of Methicillin-Resistant Staphylococcus aureus Strains Associated With a Hospital Outbreak Involving Contamination From Anesthesia Equipment Using UV-C

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Product

Resources

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Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India

Genomic Portrait of Community-Associated Methicillin-Resistant Staphylococcus Aureus ST772-SCCmec V Lineage From India