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 mecA, mecC, 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.
Highlights
Worldwide, Staphylococcus aureus is the primary causative agent of community-acquired skin and soft tissue infections (SSTI) and is an important cause of hospital-associated invasive infections including bacteremia, pneumonia and endocarditis (Bell et al, 2002; David and Daum, 2010)
All Methicillin Resistant S. aureus (MRSA) isolated from any site with a clinical infection during the 4-months period were included in the study
Based on the 19 spa types identified, the isolates could be grouped into nine MLST clonal complexes (CC) including: CC5 (n = 59 isolates), CC30 (n = 18), CC1 (n = 8), CC59 (n = 4), and single isolates belonging to CC6, CC8, CC45, CC97, and CC101
Summary
Staphylococcus aureus is the primary causative agent of community-acquired skin and soft tissue infections (SSTI) and is an important cause of hospital-associated invasive infections including bacteremia, pneumonia and endocarditis (Bell et al, 2002; David and Daum, 2010). Panton-Valentine leucocidin (PVL)-positive Methicillin Resistant S. aureus (MRSA) is a well-documented cause of community-associated SSTI and less commonly, life-threatening infections in immunocompetent populations. A recent report has suggested Sri Lankan hospitals have the highest prevalence of MRSA for all Asian hospitals that were included in the study (Song et al, 2011). In our study, we report on the genomic analysis of MRSA isolated from patients admitted to a major teaching hospital in Sri Lanka
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
