title: Clonal lineages detected amongst tetracycline-resistant meticillin-resistant Staphylococcus aureus isolates of a Tunisian hospital, with detection of lineage ST398.
abstract: Tetracycline resistance has been postulated as a potential phenotypic marker of livestock-associated lineage ST398 amongst meticillin-resistant Staphylococcus aureus (MRSA) clinical isolates in some European hospitals. The objective of this study was to determine if this marker could also be applied to Maghrebian countries. In total, 99 MRSA isolates were collected in a Tunisian hospital during January 2011-October 2012, and 24 tetracycline-resistant MRSA isolates of this collection were characterized. All isolates were tested for antimicrobial resistance phenotypes and genotypes, molecular typing, and virulence genes. Multilocus sequence typing showed that the majority of the isolates (19/24) belonged to clonal complex CC8 (ST247, n = 12 isolates; ST239, n = 6 isolates; ST241, n = 1 isolate). The remaining isolates belonged to CC398 (ST398, n = 1 isolate), CC5 (ST5 and ST641, n = 2 isolates), and CC80 (ST728, n = 2 isolates). Spa typing discriminated MRSA in eight spa types: bib26 (n = 12 isolates), bib26 (n = 5 isolates), bib26 (n = 2 isolates), and bib26, bib26, bib26, bib26 and the new bib26 (n = 1 isolate each). Three agr groups were found amongst the studied isolates: agr group I (n = 20 isolates), agr group II (n = 2) and agr group III (n = 2 isolates). We report the detection of one MRSA ST398-t899 isolate in the nasal sample of a farmer patient in Tunisia, representing the first report of ST398 in humans in Africa. Tetracycline resistance seems not to be a good phenotypic marker for MRSA ST398 strains in Tunisia, where CC8 was the most prevalent lineage. Continuous efforts to understand the changing epidemiology of this micro-organism are necessary not only for appropriate antimicrobial treatment and effective infection control, but also to monitor its evolution.
authors: Laboratoire des Maladies transmissibles et substances biologiquement actives, Faculté de Pharmacie, Monastir, Tunisia.
authors: Dalèle
authors: D
authors: Elhani
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté de Sciences de Tunis, Université de Tunis El Manar, Tunis, Tunisia.
authors: Haythem
authors: H
authors: Gharsa
authors: Laboratoire de Microbiologie, Hôpital Militaire de Tunis, Tunis, Tunisia.
authors: Dhia
authors: D
authors: Kalai
authors: rea de Bioquímica y Biología Molecular, Universidad de La Rioja, A, 26006 Logroño, Spain.
authors: Carmen
authors: C
authors: Lozano
authors: rea de Bioquímica y Biología Molecular, Universidad de La Rioja, A, 26006 Logroño, Spain.
authors: Paula
authors: P
authors: Gómez
authors: Service de Parasitologie, Hôpital Militaire de Tunis et Unité de recherche Epidémiologie moléculaire des infections fongiques nosocomiales (UR09DN03), Tunis, Tunisia.
authors: Jemli
authors: J
authors: Boutheina
authors: Laboratoire des Maladies transmissibles et substances biologiquement actives, Faculté de Pharmacie, Monastir, Tunisia.
authors: Mahjoub
authors: M
authors: Aouni
authors: Laboratoire de Microbiologie, Hôpital Militaire de Tunis, Tunis, Tunisia.
authors: Farouk
authors: F
authors: Barguellil
authors: rea de Bioquímica y Biología Molecular, Universidad de La Rioja, A, 26006 Logroño, Spain.
authors: Carmen
authors: C
authors: Torres
authors: Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El Manar, Tunis, Tunisia.|Laboratoire des Microorganismes et Biomolécules actives, Faculté de Sciences de Tunis, Université de Tunis El Manar, Tunis, Tunisia.
authors: Karim
authors: K
authors: Ben Slama
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D016000:Cluster Analysis; D005838:Genotype; D006761:Hospitals; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D010641:Phenotype; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013205:Staphylococcal Protein A / Q000235:genetics; D013753:Tetracycline Resistance; D015534:Trans-Activators / Q000235:genetics; D014416:Tunisia / Q000453:epidemiology
chemical_list: C095698:Agr protein, Staphylococcus aureus; D001426:Bacterial Proteins; D013205:Staphylococcal Protein A; D015534:Trans-Activators