title: Natural population dynamics and expansion of pathogenic clones of Staphylococcus aureus.
abstract: The population structure of Staphylococcus aureus carried by healthy humans was determined using a large strain collection of nonclinical origin (n = 829). High-throughput amplified fragment length polymorphism (AFLP) analysis revealed 3 major and 2 minor genetic clusters of S. aureus, which were corroborated by multilocus sequence typing. Major AFLP cluster I comprised 44.4% of the carriage isolates and showed additional heterogeneity whereas major AFLP groups II and III presented 2 homogeneous clusters, including 47.3% of all carriage isolates. Coanalysis of invasive S. aureus strains and epidemic methicillin-resistant S. aureus (MRSA) revealed that all major clusters contained invasive and multiresistant isolates. However, clusters and subclusters with overrepresentation of invasive isolates were also identified. Bacteremia in elderly adults, for instance, was caused by a IVa cluster-derived strain significantly more often than by strains from other AFLP clusters. Furthermore, expansion of multiresistant clones or clones associated with skin disease (impetigo) was detected, which suggests that epidemic potential is present in pathogenic strains of S. aureus. In addition, the virulence gene encoding Panton-Valentine leukocidin was significantly enriched in S. aureus strains causing abscesses and arthritis in comparison with the carriage group. We provide evidence that essentially any S. aureus genotype carried by humans can transform into a life-threatening human pathogen but that certain clones are more virulent than others.
authors.affiliation: University Medical Center Rotterdam, Department of Medical Microbiology and Infectious Diseases, Room L-313, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands. d.melles@erasmusmc.nl
authors.forename: Damian C
authors.initials: DC
authors.lastname: Melles
authors.forename: Raymond F J
authors.initials: RF
authors.lastname: Gorkink
authors.forename: Hélène A M
authors.initials: HA
authors.lastname: Boelens
authors.forename: Susan V
authors.initials: SV
authors.lastname: Snijders
authors.forename: Justine K
authors.initials: JK
authors.lastname: Peeters
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Moorhouse
authors.forename: Peter J
authors.initials: PJ
authors.lastname: van der Spek
authors.forename: Willem B
authors.initials: WB
authors.lastname: van Leeuwen
authors.forename: Guus
authors.initials: G
authors.lastname: Simons
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
mesh_terms: D003001:Cloning, Molecular; D016000:Cluster Analysis; D004247:DNA / Q000235:genetics; D005821:Genetic Techniques; D014644:Genetic Variation; D005822:Genetic Vectors; D016680:Genome, Bacterial; D005838:Genotype; D006801:Humans; D008712:Methicillin / Q000494:pharmacology; D008957:Models, Genetic; D005810:Multigene Family; D011110:Polymorphism, Genetic; D013045:Species Specificity; D013203:Staphylococcal Infections / Q000235:genetics*; D013211:Staphylococcus aureus / Q000235:genetics* / Q000472:pathogenicity*
chemical_list: D004247:DNA; D008712:Methicillin