Abstract
BackgroundStaphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings. Methicillin-resistant Staphylococcus aureus (MRSA) has become a global public health issue. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones isolated in a tertiary-care hospital in Mexico.ResultsFrom April 2017 to April 2018, 191 Staphylococcus aureus isolates were collected. The frequency of MRSA was 26.7%; these strains exhibited resistance to clindamycin (84.3%), erythromycin (86.2%), levofloxacin (80.3%), and ciprofloxacin (86.3%). The majority of MRSA strains harbored the SCCmec type II (76.4%) and t895 (56.8%) and t9364 (11.7%) were the most common spa types in both hospital-associated MRSA and community-associated MRSA isolates. ST5-MRSA-II-t895 (New York /Japan clone) and ST1011-MRSA-II-t9364 (New York /Japan-Mexican Variant clone) were the most frequently identified clones. Furthermore, different lineages of Clonal Complexes 5 (85.4%) and 8 (8.3%) were predominantly identified in this study.ConclusionOur study provides valuable information about the epidemiology of MRSA in a city of the central region of Mexico, and this is the first report on the association between t895 and t9364 spa types and ST5 and ST1011 lineages, respectively. These findings support the importance of permanent surveillance of MRSA aimed to detect the evolutionary changes of the endemic clones and the emergence of new strains.
Highlights
Staphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings
Sample collection S. aureus strains were obtained from one hundred ninety-one patients from the emergency department (n = 62), surgery (n = 47), intensive care unit (n = 31), internal medicine (n = 35), gynecology (n = 6), burn unit (n = 2), and outpatient service (n = 8); patients in whom samples were obtained in the outpatient service were subsequently admitted to the hospital
The majority of patients (84.4%) were discharged due to clinical improvement, 2% of patients were transferred to another hospital, 1.6% of patients requested voluntary discharge, and 11.5% of patients infected with S. aureus died
Summary
Staphylococcus aureus is a leading cause of broad-spectrum infections both in the community and within healthcare settings. The aim of this study was to examine the clinical and molecular characteristics of Staphylococcus aureus isolates and to define the population structure and distribution of major MRSA clones isolated in a tertiary-care hospital in Mexico. In 1961, one year after the introduction of methicillin into medical practice, the first methicillin-resistant Staphylococcus aureus (MRSA) strain was identified; methicillin resistance is mediated by the Staphylococcal Cassette Chromosome mec (SCCmec) genetic element [5]. This element includes the mec and ccr gene complexes, which are flanked by three junkyard regions. Variations in the genetic content and structural organization of these elements result in 13 different types and subtypes of SCCmec [7,8,9]
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