Abstract
Staphylococcus aureus is a major cause of infections. Toxic shock syndrome toxin (TSST-1) and Panton–Valentine leukocidin (PVL) are associated with severe clinical syndromes. S. aureus colonizing isolates recovered from healthcare workers and patients in the intensive care unit (ICU) of a university hospital comprising Group A were compared with those from adult non-ICU carriers (Group B). mecA, lukS/lukF-PV (Panton–Valentine leukocidin, PVL), and tst (toxic shock syndrome toxin) gene carriage was detected by PCR. Clones were identified in all methicillin-resistant S. aureus (MRSA) and toxin-positive methicillin-susceptible strains (MSSA) by pulsed-field gel electrophoresis (PFGE), agr groups, and multi locus sequencing typing (MLST). Group A included 90 S. aureus isolates, whereas Group B 53. PVL was more frequently found among MRSA vs. MSSA (p < 0.001) and in strains of Group B as compared to Group A (p < 0.001), consistent with the spread of ST80-IV. Higher incidence of tst gene carriage was identified among MSSA vs. MRSA (P 0.005) belonging mainly to ST30, and Group A vs. Group B (P 0.002). The wide dissemination of ST80-IV mainly in the community is responsible for a high percentage of PVL-positive MRSA, while silent spread of tst-positive S. aureus clones among ICU patients and personnel poses a threat of hospital transmission and possible severe infections.
Highlights
Staphylococcus aureus—especially methicillin-resistant strains (MRSA)—constitutes a major community and healthcare-associated pathogen worldwide
methicillin-resistant S. aureus (MRSA) epidemiology is related to the health care system; community-associated MRSA (CA-MRSA) isolates have been proved to disseminate among patients since 1998 [2]
The fact that 40% of colonizing S. aureus among intensive care unit (ICU) and non-ICU patients (Groups A and B) were resistant to methicillin underlines their importance to MRSA dissemination
Summary
Staphylococcus aureus—especially methicillin-resistant strains (MRSA)—constitutes a major community and healthcare-associated pathogen worldwide. In Greece, MRSA are frequently isolated from infections [1,2]. Toxins 2017, 9, 270 pathogenicity and invasiveness, including Panton–Valentine leukocidin (PVL) and staphylococcal toxic shock syndrome toxin (TSST-1), which lead to severe syndromes [2,3]. MRSA epidemiology is related to the health care system (healthcare-associated, HA-MRSA); community-associated MRSA (CA-MRSA) isolates have been proved to disseminate among patients since 1998 [2]. In Greece, during the last years, CA-MRSA clones started to infiltrate the health care system, being responsible for nosocomial MRSA infections [2]. Genes encoding PVL (lukS/lukF-PV) have been detected among methicillin-susceptible S. aureus (MSSA), but to a lesser extent [2,4,5]
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