Spa Diversity and Genetic Characterization of t127 Methicillin-resistant Staphylococcus Aureus in a Tertiary Greek Hospital

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) causes severe community and hospital acquired infections. Identification of staphylococcal cassette chromosome mec (SCCmec), multilocus-sequence typing, and sequencing of S. aureus protein A (spa) gene are used for MRSA typing. The aim was to investigate the spa types of MRSA isolates in a tertiary hospital in Greece and analyse the whole genome sequences of two t127 MRSA isolates. Methods: Totally, 39 MRSA isolates collected during July 2019 to June 2020 in “Georgios Gennimatas” General Hospital of Thessaloniki, Greece, were included in the study. Identification and antimicrobial susceptibility testing were performed using VITEK II automated system, and spa typing was performed. A minimum spanning tree was used to display the spa type frequencies and the genetic distances among them. Two t127-MRSA isolates (IM-MRSA and PD-MRSA) were selected for WGS.Results: Twenty-two different spa types were detected, with t002, t003, and t422 being the most frequent (5/39, 12.8% each), followed by t1994 (4/39, 10.3%). The isolates presented high genetic diversity and, taking into account the time between hospital admission and sampling, intrahospital spread did not occur. Even the two t127 isolates were assigned to different sequence types, ST9-XII-t127 and ST1-IVa-t127. Plasmids and genes conferring antimicrobial resistance and virulence were also identified.Conclusions: Various spa types were identified and together with the information about the time between hospital admission and sampling supports polyclonal MRSA spread in the hospital excluding a nosocomial infection. WGS provides a more detailed analysis distinguishing even the isolates belonging to the same spa type.

Susceptibility and molecular characterization of mec A- and mec B-positive community acquired methicillin-resistant Staphylococcus aureus isolates from students

Staphylococcus aureus is an organism of great public health importance. It is widely studied because it is virulent, causes life threatening disease and has ability to adapt to diverse environmental conditions and so develops resistance to antibiotics easily. As a result, there is a need for surveillance of its antibiotic resistance and resistance genes. The susceptibility and molecular characterization of methicillin resistant Staphylococcus aureus recovered from urine samples of healthy students were undertaken. Standard procedures were employed for isolation, identification, susceptibility, and polymerase chain reaction analyses. Out of 217 samples collected, 73 were confirmed Staphylococcus aureus. Most of the isolates were susceptible to ciprofloxacin and vancomycin followed by gentamicin and co-trimoxazole and least susceptible to penicillin, cefotaxime, ofloxacin and cefoxitin. Thirty-two (32) isolates were resistant to 5 antibiotics while 3 isolates were resistant to the 11 antibiotics used in this study. Sixteen phenotypically methicillin resistant isolates contained mecA gene while ten of the isolates also showed the presence of mecB gene. The characteristic Sa442 and nuc genes of Staphylococcus aureus and the presence of spa gene confirmed MRSA. Continous surveillance for antibiotic resistance and resistance genes is paramount at local, regional and national levels. Surveillance data will assist in implementing interventions. Keywords: Antibiotic resistance; Methicillin-resistant Staphylococcus aureus, mecA, mecB, CA-MRSA; Surveillance

Virulence Factors Found in Nasal Colonization and Infection of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates and Their Ability to Form a Biofilm

Hospitalizations related to Methicillin-resistant Staphylococcus aureus (MRSA) are frequent, increasing mortality and health costs. In this way, this study aimed to compare the genotypic and phenotypic characteristics of MRSA isolates that colonize and infect patients seen at two hospitals in the city of Niterói—Rio de Janeiro, Brazil. A total of 147 samples collected between March 2013 and December 2015 were phenotyped and genotyped to identify the protein A (SPA) gene, the mec staphylococcal chromosomal cassette (SCCmec), mecA, Panton-Valentine Leucocidin (PVL), icaC, icaR, ACME, and hla virulence genes. The strength of biofilm formation has also been exploited. The prevalence of SCCmec type IV (77.1%) was observed in the colonization group; however, in the invasive infection group, SCCmec type II was prevalent (62.9%). The Multilocus Sequence Typing (MLST), ST5/ST30, and ST5/ST239 analyses were the most frequent clones in colonization, and invasive infection isolates, respectively. Among the isolates selected to assess the ability to form a biofilm, 51.06% were classified as strong biofilm builders. Surprisingly, we observed that isolates other than the Brazilian Epidemic Clone (BEC) have appeared in Brazilian hospitals. The virulence profile has changed among these isolates since the ACME type I and II genes were also identified in this collection.

Bacteriological and Molecular Identification and Characterization of Staphylococcus aureus from Different Affections of Canines

Background: The present study was done to ascertain prevalence of Staphylococcus aureus from various canine affections in Banaskantha district of Gujarat, India. Along with this, use of classical and molecular techniques were compared in identification and virulence characterization of this pathogen.Methods: A total of 165 samples were collected and bacterial identification was carried out with bacteriological (phenotypic) techniques and confirmed by genus specific 16S rDNA and Staphylococcus aureus specific sa442 gene based PCR. Isolates were characterized for coagulase production, haemolysis activity and presence of spa gene. Result: Samples yielded, 88 (53.33%) Staphylococcus spp. via bacteriological and PCR methods. Clinically, 19 (21.59%), 28 (31.82%), 12 (13.64%), 15 (17.04%) and 14 (15.91%) isolates were from abscess/wound, pyoderma, respiratory problems, eye infections and Otitis, respectively. A total of 46/88 (52.27%) isolates were confirmed as Staphylococcus aureus in PCR. In tube coagulase test, 51/88 (57.95%) isolates were found positive. A tota of 42 isolates revealed presence of coa gene, including two tube coagulase negative isolates. Haemolytic activity revealed beta (51.14%) gamma (31.82%), alpha (13.64%) and alpha-beta (3.41%) haemolysis, respectively. X-region of Protein A (spa gene) was detected in 26 /46 (56.52%) isolates in PCR.

Prevalence, Antimicrobial Resistance Profiles, Virulence and Enterotoxins-Determinant Genes of MRSA Isolated from Subclinical Bovine Mastitis in Egypt

Subclinical mastitis caused by Staphylococcus aureus has worldwide public health significance. Here, we aimed to determine the prevalence of S. aureus, antimicrobial resistance profiles, and the virulence and enterotoxins determinant genes of MRSA strains that caused subclinical bovine mastitis. Milk samples were collected from 120 lactating animals (50 buffaloes and 70 dairy cattle) from different farms located in Ismailia Province (Egypt). The collected samples were investigated for subclinical mastitis using a California mastitis test. The total prevalence of S. aureus was 35.9% (84/234) with 36.3% (53/146) in cattle and 31% (31/88) in buffaloes. Antimicrobial susceptibility testing showed that 35.7% (30/84) of the isolated strains were resistant to cefoxitin, defined as methicillin-resistant S. aureus (MRSA), with 37.7% (20/53) in cattle and 32.2% (10/31) in buffaloes. Using PCR, 100% of the tested strains harbored coa and mecA genes, while 86.6% were positive for spa gene, with remarkable gene size polymorphism. Additionally, 10% of the tested strains contained the pvl gene. Further, using multiplex PCR, 26.6% of the tested samples had sea gene, two strains had sec gene and only one strain had sea and sec genes. The seb and sed genes were absent in the tested strains. In conclusion, mecA, coa and spa virulence genes were widely distributed in MRSA strains isolated from bovine milk, whereas the sea gene was the most predominant enterotoxin gene. Notably, this is the first report that emphasizes the prevalence of pvl gene of MRSA isolated from bovine milk in Egypt.

A multicentre outbreak of ST45 MRSA containing deletions in the spa gene in New South Wales, Australia

Background Early identification of MRSA by diagnostic medical microbiology laboratories enables improved antimicrobial choice and outcomes. The Cepheid Xpert® MRSA/SA BC test rapidly identifies Staphylococcus aureus bloodstream infections through spa gene detection and methicillin resistance via mecA gene detection. Recent emergence of S. aureus with deletions in the spa gene has resulted in false-negative results for this test, leading to misidentification of infections with this organism, particularly MRSA ST45. Objectives To investigate the emergence and prevalence of ST45 MRSA in New South Wales (NSW), Australia. Methods WGS read data from six NSW hospitals were collected for 131 ST45 MRSA isolates and analysed. Results Of the 131 ST45 MRSA investigated, 88.5% (116/131) contained a deletion in the spa gene that appeared to have arisen once in approximately 2010 followed by clonal expansion. Given the successful establishment of this ‘spa-deletion’ MRSA clone, the Cepheid Xpert® MRSA/SA BC test became unreliable for confirming S. aureus bacteraemia in NSW. Subsequently, the algorithm used by this test has been updated and evaluated to take into account the presence of S. aureus with either a spa deletion or SCCmec target variations. Conclusions This study highlighted the applied use of WGS for assessing diagnostic assays and informing necessary changes to ensure the viability of the Cepheid Xpert® MRSA/SA BC test in the context of the new ‘spa-deletion’ MRSA clone. It demonstrated how continued surveillance through WGS can reveal evolutionary events that may impact diagnostic assays, allowing corrective modifications to be made in real time.

MRSA screening and spa gene detection in isolates from healthcare workers at ophthalmology hospital in Egypt

Background Staphylococcus aureus has a major role in different types of eye infections as conjunctivitis, keratitis, and endophthalmitis. Methicillin-resistant Staphylococcus aureus (MRSA) was almost restricted to hospitals, but its prevalence has been increased in people outside hospitals. The cell wall of Staphylococcus aureus has protein A which can bind to the Fc portion of IgG. This ptnA is encoded by surface protein A of Staphylococcus aureus (spa) gene that contains a highly polymorphic sequence which is composed of repeats of 24-bp. Sequence typing of the spa gene repeat region is used to study the epidemiology of MRSA. The purpose of this study was screening of MRSA strains among healthcare workers (HCWs) in the Hospital of the Research Institute of Ophthalmology (RIO), Giza, Egypt, and detecting spa gene in their DNAs by PCR. Results In the present study, 81 samples from healthcare providers in the hospital of the Research Institute of Ophthalmology, Egypt, were screened for MRSA. Out of these 81 samples, 41 isolates (50.6%) were identified as coagulase-positive Staphylococcus aureus. Twelve staphylococcal isolates were resistant to both oxacillin and cefoxitin, and those were identified as MRSA with a percentage of 14.8% (12/81). Conventional PCR could detect spa gene in 10 out of 12 DNA MRSA with a percentage of 83.3% (10/12). Conclusion In the present study, the prevalence of MRSA in HCWs was 14.8%. Since amplification of spa gene by PCR is a necessary preliminary step for spa typing of MRSA and since using different primers for spa gene amplification might affect PCR results, then proper selection of the primers and thermal cycling reaction conditions are recommended for PCR performance and spa typing.