Lethal Necrotizing Pneumonia Caused by an ST398<i>Staphylococcus aureus</i>Strain

Rasigade, Jean‐Philippe; Laurent, François; Hubert, Philippe; Vandenesch, François; Étienne, Jérôme

doi:10.3201/eid1608.100317

Cited by 73 publications

(60 citation statements)

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“…ST398 methicillin-susceptible S. aureus (MSSA) isolates have been recovered from pigs (13), humans (14)(15)(16)(17), and retail meat (18). Asymptomatic human colonization and infection with ST398 MSSA are rare in the United States and Europe (19)(20)(21).…”

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confidence: 99%

Asymptomatic Carriage of Sequence Type 398, spa Type t571 Methicillin-Susceptible Staphylococcus aureus in an Urban Jail: a Newly Emerging, Transmissible Pathogenic Strain

et al. 2013

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Sequence type 398 (ST398) Staphylococcus aureus, frequently carried by livestock, has caused severe human infections and often carries transmissible antibiotic resistance genes. Among methicillin-susceptible S. aureus isolates colonizing Dallas County Jail detainees, 13.2% were ST398, spa type t571, and were genetically similar to human colonization isolates from New York, Chicago, and the Dominican Republic. Sequence type 398 (ST398) methicillin-resistant Staphylococcus aureus (MRSA) is often transmitted among livestock and animal handlers but is uncommonly associated with human disease in the United States (1). We unexpectedly identified ST398/t571 methicillin-sensitive S. aureus (MSSA) as the most common genetic background among MSSA isolates colonizing detainees in the Dallas County Jail. In this study, we compared the pulsed-field gel electrophoresis (PFGE) pulsotypes of isolates from the Dallas jail and from a single patient in Chicago with those of strains isolated in previous studies.Recognized first in Europe (2-9), ST398 MRSA has been isolated in the United States (10), Canada (11), and Latin America (12). ST398 methicillin-susceptible S. aureus (MSSA) isolates have been recovered from pigs (13), humans (14-17), and retail meat (18). Asymptomatic human colonization and infection with ST398 MSSA are rare in the United In January 2009, we screened the anterior nares and the hands of 928 detainees, housed in 68 divisions, called tanks, in the Dallas County Jail, for S. aureus carriage. Tanks had a capacity of 24 to 36 detainees. Detainees can interact with others within a single tank but have little interaction with those in other tanks. The study was approved by the Institutional Review Boards at the University of Chicago Medical Center and the University of Texas-Southwestern Medical Center. Recovered MSSA isolates were genotyped from subjects housed in a stratified random sample of 26 of the 68 tanks; all MRSA isolates were genotyped.In a separate study of S. aureus colonization among patients and household contacts (24), we also identified one patient in Chicago with ST398/t571 MSSA colonization.Multilocus sequence typing (MLST) (25), spa typing (26), PCR for the Panton-Valentine leukocidin (PVL) genes (27), and PFGE using Cfr9I digestion (22, 28) were performed. Antimicrobial susceptibilities were determined by automated testing (29).Among the 345 subjects in the 26 selected tanks, 110 (31.9%) carried MSSA. Of 158 MSSA isolates identified, 152 were available, and 34 MLST types were identified. Twenty isolates (13%) were ST398, the most common ST; all lacked PVL genes. Of the 345 subjects, the 16 (4.6%) who carried the 20 ST398 MSSA isolates were more likely than carriers of other MSSA genetic backgrounds to be female (P ϭ 0.0009) and older (P ϭ 0.01) ( Table 1).Among the 20 ST398 isolates, 18 were susceptible to ciprofloxacin, gentamicin, rifampin, and trimethoprim-sulfamethoxazole and resistant to clindamycin and erythromycin. The two other isolates differed in that one was susceptible to clindamyc...

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confidence: 99%

Asymptomatic Carriage of Sequence Type 398, spa Type t571 Methicillin-Susceptible Staphylococcus aureus in an Urban Jail: a Newly Emerging, Transmissible Pathogenic Strain

et al. 2013

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“…Given the world's milking cow population of 1.5 billion (31), up to 75 million cows can be infected worldwide. The widespread colonization of pigs with a specific lineage of MRSA, ST398 (2), and emerging infections in humans (10,22,32) showed that the animal reservoir of. S. aureus can have potentially serious consequences for human health care.…”

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confidence: 99%

Staphylococcus aureus Host Range and Human-Bovine Host Shift

Sakwińska

Giddey

Moreillon

et al. 2011

Appl Environ Microbiol

118

103

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Staphylococcus aureus is a major agent of bovine mastitis. The concomitant emergence of pig-associated methicillin-resistant S. aureus (MRSA) in human carriage and infection requires a reexamination of the host range and specificity of human-and cow-associated S. aureus strains, something which has not been systematically studied previously. The genetic relatedness of 500 S. aureus isolates from bovine mastitis cases, 57 isolates from nasal carriage of farmers, and 133 isolates from nonfarmers was determined by amplified fragment length polymorphism (AFLP) analysis and spa typing. Multilocus sequence typing (MLST) was conducted on a subset of isolates to match AFLP clusters with MLST clonal complexes (CCs). This data set allowed us to study host range and host specificity and to estimate the extent of bovine-tohuman transmission. The genotype compositions of S. aureus isolates from farmers and nonfarmers were very similar, while the mastitis isolates were quite distinct. Overall, transmission was low, but specific genotypes did show increased cow-to-human transmission. Unexpectedly, more than one-third of mastitis isolates belonged to CC8, a lineage which has not been considered to be bovine mastitis associated, but it is well known from human carriage and infection (i.e., USA300). Despite the fact that we did detect some transmission of other genotypes from cows to farmers, no transmission of CC8 isolates to farmers was detected, except for one tentative case. This was despite the close genetic relatedness of mastitis CC8 strains to nonfarmer carriage strains. These results suggest that the emergence of the new bovine-adapted genotype was due to a recent host shift from humans to cows concurrent with a loss of the ability to colonize humans. More broadly, our results indicate that host specificity is a lineage-specific trait that can rapidly evolve.The main niche and the largest reservoir of Staphylococcus aureus are human nares. On average, every third person is colonized with this facultative pathogen, making ca. 2 billion people colonized worldwide. Despite the fact that only a very small fraction of the carriers ever develop staphylococcal disease, its global burden is remarkable (27). Steadily increasing rates of colonization and infections with methicillin-resistant S. aureus (MRSA) are of special concern (20) because of the limited therapeutic options for such infections.Because of their sheer population size, farm animals constitute a potentially enormous reservoir of any pathogen. Even though the largest reservoir of S. aureus is human nares, the second largest may well be cows. The prevalence of S. aureus in bovine mastitis was estimated to be 3 to 5% (28, 34). Given the world's milking cow population of 1.5 billion (31), up to 75 million cows can be infected worldwide. The widespread colonization of pigs with a specific lineage of MRSA, ST398 (2), and emerging infections in humans (10,22,32) showed that the animal reservoir of. S. aureus can have potentially serious consequences for human health care...

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“…(2). We fully agree with their request that ST398 S. aureus infections not be systematically attributed to contact with livestock.…”

Section: Staphylococcus Aureus Strainmentioning

confidence: 77%

“…The authors report no history of livestock exposure and the spa type reported (t571) is relatively rare among livestock isolates (2,3). The isolate from the fatal case was tetracycline-susceptible and positive for PVL toxin, while livestock ST398 isolates have been almost uniformly tetracycline resistant and PVL negative.…”

Section: Staphylococcus Aureus Strainmentioning

confidence: 98%