Abstract
Staphylococcus argenteus is a globally distributed cause of human infection, but diagnostic laboratories misidentify this as Staphylococcus aureus. We determined whether there is clinical utility in distinguishing between the two. A prospective cohort study of community-onset invasive staphylococcal sepsis was conducted in adults at four hospitals in northeast Thailand between 2010 and 2013. Of 311 patients analysed, 58 (19%) were infected with S. argenteus and 253 (81%) with S. aureus. Most S. argenteus (54/58) were multilocus sequence type 2250. Infection with S. argenteus was more common in males, but rates of bacteraemia and drainage procedures were similar in the two groups. S. argenteus precipitated significantly less respiratory failure than S. aureus (5.2% versus 20.2%, adjusted OR 0.21, 95% CI 0.06–0.74, p 0.015), with a similar but non-significant trend for shock (6.9% versus 12.3%, adjusted OR 0.46, 95% CI 0.15–1.44, p 0.18). This did not translate into a difference in death at 28 days (6.9% versus 8.7%, adjusted OR 0.80, 95% CI 0.24–2.65, p 0.72). S. argenteus was more susceptible to antimicrobial drugs compared with S. aureus, and contained fewer toxin genes although pvl was detected in 16% (9/58). We conclude that clinical differences exist in association with sepsis due to S. argenteus versus S. aureus.
Highlights
Staphylococcus argenteus is a genetically divergent lineage of Staphylococcus aureus that received formal taxonomic classification in 2014 [1]
Data on clinical features of human S. argenteus infection are limited, but a study that defined the frequency of S. argenteus in three different clinical collections in northern Australia reported that this was predominantly associated with skin and soft-tissue infections, but rarely with bacteraemia [13]
This study indicates that S. argenteus is an important cause of community-acquired invasive methicillin-susceptible S. aureus sepsis in Thailand
Summary
Staphylococcus argenteus is a genetically divergent lineage of Staphylococcus aureus that received formal taxonomic classification in 2014 [1]. Discovering the existence of this new pathogenic species results in the need to determine whether S. argenteus and S. aureus should be distinguished apart in routine practice This might be necessary if S. argenteus infection is associated with different clinical manifestations, severity or outcome, and/or requires different antimicrobial regimens. S. argenteus has been reported to be more susceptible to oxidative stress and neutrophil killing in vitro, and less virulent in murine sepsis and skin infection models compared with S. aureus [13]. This raises the possibility that human S. argenteus infection may be associated with a milder course. One study detected the gene encoding staphylococcal enterotoxin B in all S. argenteus isolates cultured from villagers in the Amazonian forest [4]
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