Molecular and phenotypic evidence for the spread of three major methicillin-resistant Staphylococcus aureus clones associated with two characteristic antimicrobial resistance profiles in China

Cheng, Hang; Yuan, Wenchang; Zeng, Fanning; Hu, Qiwen; Shang, Wenjun; Tang, Dahai; Xue, Wei; Fu, Jianfeng; Liu, Jie; Liu, Nan; Zhu, Jing; Yang, Jie; Hu, Zhen; Yuan, Jizhen; Xia, Zhang; Shu, Li; Chen, Zhijin; Hu, Xiaomei; Rao, Xiancai

doi:10.1093/jac/dkt213

Cited by 55 publications

(68 citation statements)

References 34 publications

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“…44,45 Such an isolate has an exceptionally high potential to cause disease, mainly due to acquired multiple drug resistance and attenuated virulence allowing immune escape and long persistence. The acquisition of VISA type resistance seems to be accompanied by attenuation of virulence expression.…”

Section: Discussionmentioning

confidence: 99%

WalK(S221P), a naturally occurring mutation, confers vancomycin resistance in VISA strain XN108

Peng¹,

Hu²,

Shang³

et al. 2016

J. Antimicrob. Chemother.

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Section: Discussionmentioning

confidence: 99%

WalK(S221P), a naturally occurring mutation, confers vancomycin resistance in VISA strain XN108

Peng¹,

Hu²,

Shang³

et al. 2016

J. Antimicrob. Chemother.

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“…Genomic DNA was extracted using a TIANamp bacterial DNA kit (Tiangen, Beijing, China). Molecular typing methods, including SCCmec typing, multilocus sequence typing (MLST), and staphylococcal protein A (spa) gene typing, were applied to the MRSA strains of interest, as described in a previous study (3).…”

Section: Methodsmentioning

confidence: 99%

Panton-Valentine Leukocidin (PVL)-Positive Health Care-Associated Methicillin-Resistant Staphylococcus aureus Isolates Are Associated with Skin and Soft Tissue Infections and Colonized Mainly by Infective PVL-Encoding Bacteriophages

Cheng

Yuan

et al. 2015

J Clin Microbiol

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Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA), is a major human pathogen. MRSA can cause skin and soft tissue infections (SSTIs), as well as pneumonia, bacteremia, and sepsis (1). The majority of MRSA infections are caused by only a small number of clones. For example, the major clones in the United Kingdom are epidemic MRSA 15 (EMRSA-15) (clonal complex 22 [CC22] and sequence type 22 [ST22]) and EMRSA-16 (CC30 and ST36), whereas in Japan, Hungary, and the United States, the predominant clones are ST5-staphylococcal cassette chromosome mec element (SCCmec) II, ST239-SCCmec III, and ST8-SCCmec IV, respectively (1, 2). In China, the major clones are ST239-SCCmec III and ST5-SCCmec II, while ST59 is the third most common ST (3).MRSA infections can be caused by either health care-associated (HA) MRSA or community-associated (CA) MRSA. However, CA-MRSA is phenotypically and genotypically different from HA-MRSA (4). CA-MRSA is believed to mainly cause SSTIs in healthy persons without risk factors for MRSA acquisition, and it rarely causes necrotizing pneumonia (5, 6). CA-MRSA typically harbors SCCmec type IV (21 to 24 kb) or V (28 kb) and is less resistant to non-␤-lactam antibiotics. HA-MRSA persists in hospitals, causes cutaneous and invasive infections, and usually contains larger SCCmec, such as types I (34 kb), II (53 kb), or III (67 kb); thus, the resistance of HA-MRSA isolates is not restricted to ␤-lactam antibiotics, and these pathogens are often resistant to multiple types of drugs (1).Panton-Valentine leukocidin (PVL), a bicomponent poreforming cytotoxin assembled by LukS-PV and LukF-PV, has been demonstrated to have a significant function in the pathogenesis of MRSA by targeting polymorphonuclear cells, monocytes, and macrophages (7). Epidemiological studies have revealed that the PVL genes are carried mainly by CA-MRSA (8). However, PVL genes carried by HA-MRSA strains have also been described (9, 10). In China, an analysis conducted between 2005 and 2006 of 702 MRSA isolates from 18 teaching hospitals in 14 cities showed that the carriage rate of PVL genes in MRSA strains was 2.3%, and all PVL-positive isolates were considered to be HA-MRSA based on patient medical records (11). In a teaching hospital in Wenzhou, 11.9% of the HA-MRSA isolates were PVL positive (12). The risk of the prevalent PVL-positive HA-MRSA strains is a se-

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“…Among 159 ST239 and 78 ST5 MRSA strains collected in China, ST239 strains contained spa types t030, t037, t138, t459, t632 and t3167 and ST5 strains included t002, t010, t570, t2460 and t045 (Cheng et al, 2013). The different spa types carried by one S. aureus ST clone may be helpful for tracing the strains within the ST clone, especially for the new emerging ST clones, such as ST121.…”

Section: Molecular Types Of S Aureus Clone St121mentioning

confidence: 99%

Staphylococcus aureus ST121: a globally disseminated hypervirulent clone

Rao

Shang

et al. 2015

Journal of Medical Microbiology

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Staphylococcus aureus is a leading cause of bacterial infections in hospitals and communities worldwide. With the development of typing methods, several pandemic clones have been well characterized, including the extensively spreading hospital-associated meticillin-resistant S. aureus (HA-MRSA) clone ST239 and the emerging hypervirulent community-associated (CA) MRSA clone USA300. The multilocus sequence typing method was set up based on seven housekeeping genes; S. aureus groups were defined by the sharing of alleles at $5 of the seven loci. In many cases, the predicted founder of a group would also be the most prevalent ST within the group. As a predicted founder of major S. aureus groups, approximately 90 % of ST121 strains was meticillin-susceptible S. aureus (MSSA). The majority of ST121 strains carry accessory gene regulator type IV, whereas staphylococcal protein A gene types for ST121 are exceptionally diverse. More than 90 % of S. aureus ST121 strains have Panton-Valentine leukocidin; other enterotoxins, haemolysins, leukocidins and exfoliative toxins also contribute to the high virulence of ST121 strains. Patients suffering from S. aureus ST121 infections often need longer hospitalization and prolonged antimicrobial therapy. In this review, we tried to summarize the epidemiology of the S. aureus clone ST121 and focused on the molecular types, toxin carriage and disease spectrum of this globally disseminated clone.

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Molecular and phenotypic evidence for the spread of three major methicillin-resistant Staphylococcus aureus clones associated with two characteristic antimicrobial resistance profiles in China

Abstract: The predominant MRSA clones in China were associated with characteristic antimicrobial resistance profiles. Antibiotics for treating patients with MRSA infections can be selected based on the strain typing data.

Cited by 55 publications

References 34 publications

WalK(S221P), a naturally occurring mutation, confers vancomycin resistance in VISA strain XN108

WalK(S221P), a naturally occurring mutation, confers vancomycin resistance in VISA strain XN108

Panton-Valentine Leukocidin (PVL)-Positive Health Care-Associated Methicillin-Resistant Staphylococcus aureus Isolates Are Associated with Skin and Soft Tissue Infections and Colonized Mainly by Infective PVL-Encoding Bacteriophages

Staphylococcus aureus ST121: a globally disseminated hypervirulent clone

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