Abstract
The prevalent Staphylococcus aureus clones and antibiotic susceptibility profiles are known to change dynamically and geographically; however, recent S. aureus strains causing infections in women and children in China have not been characterized. In this study, we analyzed the molecular epidemiology and antimicrobial resistance of S. aureus isolated from patients in four centers for women and children in Guangzhou, China. In total, 131 S. aureus isolates (100 from children and 31 from women) were analyzed by spa typing, multi-locus sequence typing, virulence gene and antimicrobial resistance profiling, staphylococcal chromosomal cassette mec typing, and mutation analyses of rpoB. A total of 58 spa types, 27 sequence types (STs), and 10 clonal complexes (CCs) were identified. While CC59 (ST59-IV, 48.8%; ST338-III, 35.7%) and CC45 (ST45-IV, 100%) were the major clones (84.4%) among MRSA isolates, CC5 (ST188, 24.3%; ST1, 21.6%) and CC398 (ST398, 70%) were the major ones (70.1%) among MSSA isolates. ST338-MRSA-III mostly found in pus but hardly in respiratory tract samples while ST45-MRSA-IV was on the opposite, even though they both found in blood and cerebrospinal fluid sample frequently. Staphylococcal enterotoxin genes seb-seq-sek were strongly associated with ST59 and ST338, while sec was associated with ST45, ST121, ST22, and ST30. All ST338, ST1232, and SCCmec III isolates carried lukF/S-PV genes. A total of 80% of ST338 isolates were resistant to erythromycin, clindamycin, and tetracycline. All ST45 isolates exhibited intermediate or complete resistance to rifampicin. In total, 481 HIS/ASN mutations in rpoB were found in rifampicin-resistant or intermediate-resistant isolates. ST338-III and ST45-IV emerged as two of three major clones in MRSA isolates from women and children in Guangzhou, China, though ST59-MRSA-IV remained the most prevalent MRSA clone. Clonal distribution of S. aureus varied, depending on the specimen source. Virulence genes and antibiograms were closely associated with the clonal lineage. These results clarified the molecular epidemiology of S. aureus from women and children in Guangzhou, China, and provide critical information for the control and treatment of S. aureus infections.
Highlights
Staphylococcus aureus is one of the most common pathogens in China, causing a variety of infections, including skin and soft tissue infections (SSTIs), deep-seated abscess, osteoarthritis, necrotizing pneumonia, sepsis, meningitis, and so on (Qiao et al, 2013; Xiao et al, 2015)
Resistant was defined as a given antibiotic when it was inhibited in vitro by a concentration of this drug that is associated with a high likelihood of therapeutic failure while sensitive is associated with a high likelihood of therapeutic success
We investigated the prevalence, virulence genes, and antimicrobial resistance patterns of 131 isolates (67 MSSA and 64 MRSA) collected from four centers for women and children in Guangzhou, southern China
Summary
Staphylococcus aureus is one of the most common pathogens in China, causing a variety of infections, including skin and soft tissue infections (SSTIs), deep-seated abscess, osteoarthritis, necrotizing pneumonia, sepsis, meningitis, and so on (Qiao et al, 2013; Xiao et al, 2015). Prevalent MRSA clones have been changing over the years, from ST239 in 2013 to ST59-MRSA in 2016, among bloodstream isolates across China (Li et al, 2018). The ST45-MRSA-IV clone, known as the Berlin epidemic strain, either colonizing nares or causing bloodstream infections or respiratory care ward outbreak in Taiwan, is seldom reported in China (Moore et al, 2010; Lee et al, 2011; Monecke et al, 2011; Chow et al, 2017)
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