Genomic and Epidemiological Evidence of a Dominant Panton-Valentine Leucocidin-Positive Methicillin Resistant Staphylococcus aureus Lineage in Sri Lanka and Presence Among Isolates From the United Kingdom and Australia

Abstract

Objective: To undertake the first detailed genomic analysis of methicillin-resistant Staphylococcus aureus (MRSA) isolated in Sri Lanka. Methods: A prospective observational study was performed on 94 MRSA isolates collected over a 4 months period from the Anuradhapura Teaching Hospital, Sri Lanka. Screening for mec A, mec C, and the Panton-Valentine leucocidin (PVL)-associated lukS-PV/lukF-PV genes and molecular characterization by spa typing was undertaken. Whole genome sequencing (WGS) and phylogenetic analysis was performed on selected multilocus sequence type (MLST) clonal complex 5 (CC5) isolates from Sri Lanka, England, Australia, and Argentina. Results: All 94 MRSA harbored the mecA gene. Nineteen spa types belonging to nine MLST clonal complexes were identified. Where origin of the sample was recorded, most isolates were from skin and soft tissue infections (70/91; 76.9%), with fewer causing bacteremia (16/91; 17.6%), empyema (3/91; 3.3%) and osteomyelitis (2/91; 2.2%). Sixty two (65.9%) isolates were PVL positive with the majority (56 isolates; 90.3%) belonging to a dominant CC5 lineage. This lineage, PVL-positive ST5-MRSA-IVc, was associated with both community and hospital-onset infections. Based on WGS, representative PVL-positive ST5-MRSA-IVc isolates from Sri Lanka, England and Australia formed a single phylogenetic clade, suggesting wide geographical circulation. Conclusions: We present the most detailed genomic analysis of MRSA isolated in Sri Lanka to date. The analysis identified a PVL-positive ST5-MRSA-IVc that is prevalent among MRSA causing clinical infections in Sri Lanka. Furthermore, this clone was also found among isolates from the United Kingdom and Australia.

A preliminary study of Aminoglycoside Modifying Enzymes (AMEs) of Multiple Antibiotic Resistance of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Al-Diwaniya/Iraq

“…The full (100%) dissemination of the mecA gene in MRSA strains are in (Figure2 and Table 4). This finding matches with other reports in West Bank-Palestine and Sri Lanka that found all 112 and 94 S. aureus (100%) isolated from different lesions as MRSA strains were caring mecAgene (Hadyeh et al, 2019;McTavish et al, 2019) respectively. This agrees with Goudarzi et al (2019b) in Iran as 78.6% (66/84) of MRSA strains were found to be MDR.…”

Genotyping of methicillin resistant Staphylococcus aureus from the United Arab Emirates

“…Recently reported phylogenetic analysis of CC5 PVL-positive MRSA from four continents showed geographical clustering with the identification of the ST5-PVL-positive MRSA-IVc Sri Lanka clone 24 . Wider geographical spread of this clone was demonstrable with its identification in England and Australia where demonstrable links to Sri Lanka were not consistently established 24 . Our study documents the first report of CC5-MRSA-IV Sri Lanka Clone with two distinct variants based on carriage or absence of enterotoxin genes ( sed, sej, ser ) in our setting.…”

Characterization of PVL-Positive MRSA Isolates in Northern Bavaria, Germany over an Eight-Year Period

“…CC5, found 12-times in our study, ranged among the predominant MRSA lineages in Germany between 2000 and 2010 [ 25 ] and also in 2015 and 2016 [ 22 ]. One CC5 isolate in our study was assigned to Sri Lanka, in which CC5 is prevalent [ 26 ]. CC772 is also known as a Bengal clone, first reported from India and later identified in the Bengal Bay area [ 27 ].…”