J Bacteriol Virol.  2016 Jun;46(2):99-103. 10.4167/jbv.2016.46.2.99.

Prevalence and Molecular Characteristics of Methicillin-resistant Staphylococcus aureus Isolates in a Neonatal Intensive Care Unit

• Kim SY
• Park SH
• Hwang SM

• KMID: 2327905
• DOI: http://doi.org/10.4167/jbv.2016.46.2.99

Abstract

The molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolated from neonates in a neonatal intensive care unit (NICU) were investigated by multilocus sequence typing (MLST), staphylocoagulase (SC) genotyping, staphylococcal cassette chromosome mec (SCCmec) typing, accessory gene regulator (agr) typing, and the presence of Panton-Valentine leukocidin (PVL). Among the 44 S. aureus isolates from nares in neonates between March and June 2014 at hospital in Busan, 27 (61.4%) were MRSA and 17 (38.6%) were methicillin-susceptible S. aureus (MSSA). The most prevalent clone in MRSA isolates was ST72-SC type Vb-SCCmec IV-agr I (n=26) and the remaining one was ST89-SC type I-SCCmec II-agr II. In MSSA isolates, the prevalent clone was ST121-SC type Va-agr IV (n=13), followed by ST72-SC type Vb-agr I (n=2), ST8-SC type III-agr I (n=1) and ST15-SC type X-agr II (n=1). All isolates did not possess the PVL. The data showed that the neonates in NICU carried high prevalence of ST72 MRSA and remarkably different clones with SC diversity between MRSA and MSSA isolates.

Keyword

MRSA; NICU; Multilocus sequence type; Staphylocoagulase type; SCCmec type

MeSH Terms

Busan
Clone Cells
Coagulase
Humans
Infant, Newborn
Intensive Care, Neonatal*
Leukocidins
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Multilocus Sequence Typing
Prevalence*
Coagulase
Leukocidins

Reference

1). Pereira VC, Riboli DF, da Cunha Mde L. Characterization of the clonal profile of MRSA isolated in neonatal and pediatric intensive care units of a University Hospital. Ann Clin Microbiol Antimicrob. 2014; 13:50.

2). David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010; 23:616–87.

3). Jevons MP. "Celbenin"-resistant Staphylococci. Br Med J. 1961; 14:124–5.

4). Grundmann H, Aires-de-Sousa M, Boyce J, Tiemersma E. Emergence and resurgence of methicillin-resistant Staphylococcus aureus as a public-health threat. Lancet. 2006; 368:874–85.

5). Chen CJ, Huang YC. New epidemiology of Staphylococcus aureus infection in Asia. Clin Microbiol Infect. 2014; 20:605–23.

6). Bae IG, Kim JS, Kim S, Heo ST, Chang C, Lee EY. Genetic correlation of community-associated methicillin-resistant Staphylococcus aureus strains from carriers and from patients with clinical infection in one region of Korea. J Korean Med Sci. 2010; 25:197–202.

7). Kim ES, Song JS, Lee HJ, Choe PG, Park KH, Cho JH, et al. A survey of community-associated methicillin-resistant Staphylococcus aureus in Korea. J Antimicrob Chemother. 2007; 60:1108–14.

8). Kim ES, Lee HJ, Chung GT, Lee YS, Shin DH, Jung SI, et al. Molecular characterization of methicillin-resistant Staphylococcus aureus isolates in Korea. J Clin Microbiol. 2011; 49:1979–82.

9). Song JH, Hsueh PR, Chung DR, Ko KS, Kang CI, Peck KR, et al. Spread of methicillin-resistant Staphylococcus aureus between the community and the hospitals in Asian countries: an ANSORP study. J Antimicrob Chemother. 2011; 66:1061–9.

10). Lee SS, Kim YJ, Chung DR, Jung KS, Kim JS. Invasive infection caused by a community-associated methicillin-resistant Staphylococcus aureus strain not carrying Panton-Valentine leukocidin in South Korea. J Clin Microbiol. 2010; 48:311–3.

11). Park SH, Kim KJ, Kim BK, Hwang SM. Molecular characterization of community-associated methicillin-resistant and methicillin-susceptible Staphylococcus aureus isolates from children with skin infections in Busan, Korea. J Bacteriol Virol. 2015; 45:104–111.

12). Lamers RP, Stinnett JW, Muthukrishnan G, Parkinson CL, Cole AM. Evolutionary Analyses of Staphylococcus aureus identify genetic relationships between nasal carriage and clinical isolates. PLoS One. 2011; 6:e16426.

13). Nelson MU, Gallagher PG. Methicillin-resistant Staphylococcus aureus in the neonatal intensive care unit. Semin Perinatol. 2012; 36:424–30.

14). Carey AJ, Long SS. Staphylococcus aureus: a contin-uously evolving and formidable pathogen in the neonatal intensive care unit. Clin Perinatol. 2010; 37:535–46.

15). David MD, Kearns AM, Gossain S, Ganner M, Holmes A. Community-associated methicillin-resistant Staphylococcus aureus: nosocomial transmission in a neonatal unit. J Hosp Infect. 2006 Nov; 64:244–50.

16). Enright MC, Day NP, Davies CE, Peacock SJ, Spratt BG. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol. 2000; 38:1008–15.

17). Ichiyama S, Ohta M, Shimokata K, Kato N, Takeuchi J. Genomic DNA fingerprinting by pulsed-field gel electrophoresis as an epidemiological marker for study of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. J Clin Microbiol. 1991; 29:2690–95.

18). Oliveira DC, de Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2002; 46:2155–61.

19). Tenover FC, Vaughn RR, McDougal LK, Fosheim GE, McGowan JE Jr. Multiple-locus variable-number tandem-repeat assay analysis of methicillin-resistant Staphylococcus aureus strains. J Clin Microbiol. 2007; 45:2215–9.

20). Feil EJ, Enright MC. Analyses of clonality and the evolution of bacterial pathogens. Curr Opin Microbiol. 2004; 7:308–13.

21). Shopsin B, Mathema B, Alcabes P, Said-Salim B, Lina G, Matsuka A, et al. Prevalence of agr specificity groups among Staphylococcus aureus strains colonizing Children and their guardians. J Clin Microbiol. 2003; 41:456–9.

22). Watanabe S, Ito T, Sasaki T, Li S, Uchiyama I, Kishii K, et al. Genetic diversity of staphylocoagulase genes (coa): insight into the evolution of variable chromosomal virulence factors in Staphylococcus aureus. PLoS One. 2009; 4:e5714.

23). Murakami K, Minamide W, Wada K, Nakamura E, Teraoka H, Watanabe S. Identification of methicillin-resistant strains of staphylococci by polymerase chain reaction. J Clin Microbiol. 1991; 29:2240–4.

24). Hirose M, Kobayashi N, Ghosh S, Paul SK, Shen T, Urushibara N, et al. Identification of staphylocoagulase genotypes I-X and discrimination of type IV and V subtypes by multiplex PCR assay for clinical isolates of Staphylococcus aureus. Jpn J Infect Dis. 2010; 63:257–63.

25). Lina G, Piemont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, et al. Involvement of Panton-Valentine leukocidin producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999; 29:1128–32.

26). Sung JY, Lee J, Choi EH, Lee HJ. Changes in molecular epidemiology of community-associated and health care-associated methicillin-resistant Staphylococcus aureus in Korean children. Diagn Microbiol Infect Dis. 2012; 74:28–33.

27). Lee J, Sung JY, Kim YM, Oh CE, Kim HB, Choi EH, et al. Molecular characterization of methicillin-resistant Staphylococcus aureus obtained from the anterior nares of healthy Korean children attending daycare centers. Int J Infect Dis. 2011; 15:558–63.

28). McDougal LK, Steward CD, Killgore GE, Chaitram JM, McAllister SK, Tenover FC. Pulsed-field gel electrophoresis typing of oxacillin-resistant Staphylococcus aureus isolates from the United States: establishing a national database. J Clin Microbiol. 2003; 41:5113–20.

29). Hwang SM, Kim TU. Changes in coagulase serotype of Staphylococcus aureus isolates in Busan, 1994–2005. Kor J Microbiol. 2007; 43:346–50.