Abstract
BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) ST398 is a livestock associated-bacterium that is most prevalent in Europe. Human-adapted MRSA ST398 was recently reported from China, but there is no data available yet for Taiwan.MethodsTo identify S. aureus ST398 isolates, we examined 6413 S. aureus isolates (5632 MRSA and 781 susceptible strains) that were collected in Taiwan between 1995 and 2017. If isolates could not be typed by pulsed-field gel electrophoresis upon Sma I digestion, we performed further characterization and complete genome sequencing.ResultsWe identified 18 ST398 S. aureus isolates from 16 subjects (0.28%), including 6 sensitive and 12 resistant strains. Of these, 14 were colonizing isolates, 3 were clinical (infecting) isolates and one isolate was from a pork specimen. All 3 infecting isolates were MSSA strains identified in 2015 from two children with recurrent otitis media or sinusitis. The other 3 MSSA isolates were identified from workers handling pork (2) or pork meat (1) in 2015. The first 5 MRSA colonizing isolates were identified from residents in two nursing homes in 2012. Six MRSA isolates were identified from residents and foreign employees at a nursing home in 2016 and one MRSA from a foreign worker in 2017. Phylogenetic analysis of genome sequences indicated that all 12 local ST398 MRSA strains cluster together, human-adapted and phylogenetically related to a human MRSA strain identified in China in 2002. Two local MSSA isolates could be linked to isolates from livestock. The toxin profiles were similar for the MRSA and MSSA isolates.ConclusionsOur results demonstrate that S. aureus ST398 was present in Taiwan in 2012 and potentially earlier. Although some isolates could be linked to livestock, most ST398 S. aureus isolates identified in Taiwan, particularly MRSA, represent human-adapted strains. Local transmission of human-adapted MRSA ST398 strains has occurred in nursing homes in Taiwan, possibly after import from China. Further surveillance is needed.
Highlights
In addition to being a human pathogen, methicillinresistant Staphylococcus aureus (MRSA) can colonize and cause diseases in a variety of animals, which as known as livestock-associated Methicillin-resistant Staphylococcus aureus (MRSA) (LA-MRSA) [1, 2]
Identifying ST398 S. aureus isolates in Taiwan Among the pool of 6413 isolates, we identified 18 (0.28%) ST398 S. aureus isolates, including 12 MRSA and 6 methicillin-susceptible S. aureus (MSSA)
Five MRSA isolates were identified from five residents in two nursing homes (NHs) in a survey conducted in 2012 for MRSA carriage among residents and health care workers (HCWs) in 14 nursing homes island-wide [15]
Summary
In addition to being a human pathogen, methicillinresistant Staphylococcus aureus (MRSA) can colonize and cause diseases in a variety of animals, which as known as livestock-associated MRSA (LA-MRSA) [1, 2]. LA-MRSA has been increasingly identified in humans and has been associated with very severe diseases and even death [1, 2]. In contrast to a declining trend of HA-MRSA incidence observed in 2000s, CA-MRSA infections have been increasingly reported, in pediatric patients [15,16,17]. LA-MRSA was identified from pigs and humans recently and caused minor to life-threatening human infections [18]. Human-adapted MRSA ST398 was recently reported from China, but there is no data available yet for Taiwan
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