title: Methicillin-susceptible Staphylococcus aureus endocarditis isolates are associated with clonal complex 30 genotype and a distinct repertoire of enterotoxins and adhesins.
abstract: BACKGROUND
  Using multinational collections of methicillin-susceptible Staphylococcus aureus (MSSA) isolates from infective endocarditis (IE) and soft tissue infections (STIs), we sought to (1) validate the finding that S. aureus in clonal complex (CC) 30 is associated with hematogenous complications and (2) test the hypothesis that specific genetic characteristics in S. aureus are associated with infection severity.
  
  
  METHODS
  IE and STI isolates from 2 cohorts were frequency matched by geographic origin. Isolates underwent spa typing to infer CC and multiplex polymerase chain reaction for presence of virulence genes.
  
  
  RESULTS
  114 isolate pairs were genotyped. IE isolates were more likely to be CC30 (19.5% vs 6.2%; P = .005) and to contain 3 adhesins (clfB, cna, map/eap; P < .0001 for all) and 5 enterotoxins (tst, sea, sed, see, and sei; P ≤ .005 for all). CC30 isolates were more likely to contain cna, tst, sea, see, seg, and chp (P < .05 for all).
  
  
  CONCLUSIONS
  MSSA IE isolates were significantly more likely to be CC30 and to possess a distinct repertoire of virulence genes than MSSA STI isolates from the same region. The genetic basis of this association requires further study.
authors.affiliation: Duke University Medical Center Division of Infectious Diseases and International Health, Durham, North Carolina, USA.
authors.forename: Juhsien J C
authors.initials: JJ
authors.lastname: Nienaber
authors.forename: Batu K
authors.initials: BK
authors.lastname: Sharma Kuinkel
authors.forename: Michael
authors.initials: M
authors.lastname: Clarke-Pearson
authors.forename: Supaporn
authors.initials: S
authors.lastname: Lamlertthon
authors.forename: Lawrence
authors.initials: L
authors.lastname: Park
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Rude
authors.forename: Steve
authors.initials: S
authors.lastname: Barriere
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Woods
authors.forename: Vivian H
authors.initials: VH
authors.lastname: Chu
authors.forename: Mercedes
authors.initials: M
authors.lastname: Marín
authors.forename: Suzana
authors.initials: S
authors.lastname: Bukovski
authors.forename: Patricia
authors.initials: P
authors.lastname: Garcia
authors.forename: G Ralph
authors.initials: GR
authors.lastname: Corey
authors.forename: Tony
authors.initials: T
authors.lastname: Korman
authors.forename: Thanh
authors.initials: T
authors.lastname: Doco-Lecompte
authors.forename: David R
authors.initials: DR
authors.lastname: Murdoch
authors.forename: L Barth
authors.initials: LB
authors.lastname: Reller
authors.forename: Vance G
authors.initials: VG
authors.lastname: Fowler
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics*; D000328:Adult; D000368:Aged; D001315:Australia; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000235:genetics*; D004697:Endocarditis, Bacterial / Q000235:genetics*; D004768:Enterotoxins / Q000235:genetics*; D005060:Europe; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D008877:Middle East; D058885:Multilocus Sequence Typing; D009520:New Zealand; D009656:North America; D012720:Severity of Illness Index; D018461:Soft Tissue Infections / Q000235:genetics*; D013203:Staphylococcal Infections / Q000235:genetics*; D013211:Staphylococcus aureus / Q000235:genetics* / Q000472:pathogenicity; D037521:Virulence Factors / Q000235:genetics
chemical_list: D018829:Adhesins, Bacterial; D004269:DNA, Bacterial; D004768:Enterotoxins; D037521:Virulence Factors