title: Prevalence and molecular characterization of methicillin-resistant Staphylococcus aureus ST398 resistant to tetracycline at a Spanish hospital over 12 years.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) ST398, associated with livestock animals, was described in 2003 as a new lineage infecting or colonizing humans. We evaluated the prevalence and molecular characteristics of MRSA ST398 isolated in the Hospital Universitari de Bellvitge from January 2000 to June 2011. Tetracycline resistant (Tet-R) MRSA isolates from single patients (pts) were screened by SmaI-pulsed field gel electrophoresis (PFGE). Nontypable MRSA strains by SmaI (NT Sma I)-MRSA were further analysed by ApaI-PFGE, spa, SCCmec, agr, MLST typing, and by DNA microarray hybridization. Among 164 pts harboring Tet-R MRSA, NT Sma I-MRSA ST398-agrI was found in 33 pts (20%). Although the first pt was detected in 2003, 22/33 pts (67%) were registered in the 2010-2011 period. Ten pts (30%) were infected and cancer was the most frequent underlying disease. In one case, death was due to MRSA-ST398-related infection. Five pulsotypes (A-E) were detected using ApaI-PFGE, with type A accounting for 76% of the strains. The majority of the studied isolates presented spa type t011 (70%) and SCCmec type V (88%). One strain was spa negative both by PCR and microarray analysis. Forty-nine percent of the studied isolates showed resistance to 3 or more antibiotic classes, in addition to beta-lactams. Ciprofloxacin resistance was 67%. Tet-R was mediated by tet(M) and tet(K) in 26 isolates. All isolates lacked Panton-Valentine Leukocidin production, as well as other significant toxins. This study displays the molecular features of MRSA-ST398 clone and shows the increase in tetracycline resistance together with arise in MRSA-ST398 isolates infecting or colonizing patients in our clinical setting.
authors.affiliation: Department of Microbiology, Hospital Universitari de Bellvitge, Barcelona, Spain ; Epidemiology of Bacterial Infections Group, IDIBELL, Barcelona, Spain ; Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, Barcelona, Spain ; Spanish Network for the Research in Infectious Diseases (REIPI RD06/0008), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Mariana
authors.initials: M
authors.lastname: Camoez
authors.forename: Josep M
authors.initials: JM
authors.lastname: Sierra
authors.forename: Miquel
authors.initials: M
authors.lastname: Pujol
authors.forename: Ana
authors.initials: A
authors.lastname: Hornero
authors.forename: Rogélio
authors.initials: R
authors.lastname: Martin
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Domínguez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013752:Tetracycline / Q000494:pharmacology; D013753:Tetracycline Resistance / Q000235:genetics*
chemical_list: D013752:Tetracycline
references.citation: J Antimicrob Chemother. 2009 Dec;64(6):1156-64
references.pmid: 19808235
references.citation: Emerg Infect Dis. 2007 Feb;13(2):255-8
references.pmid: 17479888
references.citation: Emerg Infect Dis. 2008 Aug;14(8):1271-2
references.pmid: 18680653
references.citation: PLoS One. 2009 Aug 27;4(8):e6800
references.pmid: 19710922
references.citation: Clin Microbiol Infect. 2007 Mar;13(3):236-49
references.pmid: 17391377
references.citation: Microb Drug Resist. 2000 Fall;6(3):189-98
references.pmid: 11144419
references.citation: Clin Microbiol Infect. 2008 Apr;14(4):381-4
references.pmid: 18190580
references.citation: Comp Immunol Microbiol Infect Dis. 2012 Dec;35(6):513-21
references.pmid: 22640551
references.citation: Trends Microbiol. 2005 Dec;13(12):596-601
references.pmid: 16242332
references.citation: Emerg Infect Dis. 2010 Jan;16(1):157-9
references.pmid: 20031071
references.citation: Emerg Infect Dis. 2005 Dec;11(12):1965-6
references.pmid: 16485492
references.citation: Appl Environ Microbiol. 2003 Jan;69(1):18-23
references.pmid: 12513972
references.citation: PLoS One. 2009;4(1):e4258
references.pmid: 19145257
references.citation: PLoS One. 2011 Feb 09;6(2):e16830
references.pmid: 21347386
references.citation: Emerg Infect Dis. 2008 Mar;14(3):479-83
references.pmid: 18325267
references.citation: Clin Microbiol Infect. 2012 Aug;18(8):745-55
references.pmid: 22509728
references.citation: J Clin Microbiol. 2000 Mar;38(3):1008-15
references.pmid: 10698988
references.citation: J Antimicrob Chemother. 2012 Dec;67(12):2804-8
references.pmid: 22899804
references.citation: Emerg Infect Dis. 2009 Jul;15(7):1098-101
references.pmid: 19624929
references.citation: Appl Environ Microbiol. 2010 Feb;76(3):652-8
references.pmid: 20023093
references.citation: J Clin Microbiol. 2008 Feb;46(2):574-81
references.pmid: 18032612
references.citation: Clin Microbiol Infect. 2010 Jul;16(7):1017-9
references.pmid: 19681955
references.citation: mBio. 2012 Feb 21;3(1):
references.pmid: 22354957
references.citation: Antimicrob Agents Chemother. 2007 Sep;51(9):3374-7
references.pmid: 17576837
references.citation: J Antimicrob Chemother. 2012 Feb;67(2):330-4
references.pmid: 22127589
references.citation: Emerg Infect Dis. 2011 Mar;17(3):502-5
references.pmid: 21392444
references.citation: Clin Microbiol Infect. 2007 Oct;13 Suppl 3:1-46
references.pmid: 17716294
references.citation: J Clin Microbiol. 2012 Oct;50(10):3186-92
references.pmid: 22814464
references.citation: Emerg Infect Dis. 2005 May;11(5):711-4
references.pmid: 15890125
references.citation: Emerg Infect Dis. 2007 Dec;13(12):1834-9
references.pmid: 18258032
references.citation: Emerg Infect Dis. 2009 May;15(5):845-7
references.pmid: 19402995
references.citation: Emerg Infect Dis. 2010 Apr;16(4):587-94
references.pmid: 20350371
references.citation: FEMS Immunol Med Microbiol. 2008 Jul;53(2):237-51
references.pmid: 18507678