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Emergence of a mupirocin-resistant, methicillin-susceptible Staphylococcus aureus clone associated with skin and soft tissue infections in Greece

dc.creatorGiormezis N., Doudoulakakis A., Tsilipounidaki K., Militsopoulou M., Kalogeras G., Stamouli V., Kolonitsiou F., Petinaki E., Lebessi E., Spiliopoulou I.en
dc.date.accessioned2023-01-31T07:42:26Z
dc.date.available2023-01-31T07:42:26Z
dc.date.issued2021
dc.identifier10.1186/s12866-021-02272-5
dc.identifier.issn14712180
dc.identifier.urihttp://hdl.handle.net/11615/72410
dc.description.abstractBackground: Staphylococcus aureus causes various infections, including skin and soft tissue infections (SSTIs). In this study, methicillin-susceptible S. aureus (MSSA) from SSTIs among patients in three tertiary-care hospitals in Greece were studied in terms of antimicrobial resistance, clonal distribution, toxin and adhesin genes carriage. Results: During a five-year period (2014–2018), 6145 S. aureus were recovered from 13,244 patients with SSTIs and tested for antimicrobial susceptibility. MSSA were 4806 (78.21 %) including 1484 isolates with mupirocin minimum inhibitory concentration (MIC) > 64 mg/L (30.88 %). Two hundred and sixty representative mupirocin-resistant MSSA were analyzed for genes encoding Panton-Valentine leukocidin (PVL, lukS/lukF-PV), exfoliative toxins (eta, etb), adhesin FnbA (fnbA) and resistance genes mupA (high-level resistance to mupirocin), fusB (fusidic acid), aminoglycosides’ modifying enzymes, ermA, ermC and msrA (macrolides/lincosamides) by PCRs. Strains were classified into clones by PFGE and MLST. All mupirocin-resistant MSSA were penicillin-resistant; 92.7 % expressed resistance to fusidic acid and 88.9 % to tobramycin. All 260 molecularly analyzed isolates were mupA-positive; all fusidic acid-resistant (241/260) carried fusB whereas, the tobramycin-resistant ones (230), ant(4′)-Ia. The majority carried eta (93.85 %), etb (98.08 %) and fnbA (88.85 %). PFGE typing revealed a mostly unvarying population; 260 MSSA were grouped into three types. One major eta/etb-positive clone comprising of 258/260 strains (99.2 %), PFGE type 1, was classified as ST121, including nine strains co-carrying PVL. Another PVL-positive strain was identified as ST1, and one toxins-negative as ST21. Conclusions: A mupirocin-resistant MSSA clone, ST121, carrying resistance, exfoliative toxins and adhesin genes, was spread and predominated in SSTIs from patients in Greece during the five-year studied period. © 2021, The Author(s).en
dc.language.isoenen
dc.sourceBMC Microbiologyen
dc.source.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85109184173&doi=10.1186%2fs12866-021-02272-5&partnerID=40&md5=36367b9bad57f29820b62eb4ff97017e
dc.subjectadhesinen
dc.subjectaminoglycosideen
dc.subjectampicillinen
dc.subjectcefoxitinen
dc.subjectchloramphenicolen
dc.subjectciprofloxacinen
dc.subjectclindamycinen
dc.subjectcotrimoxazoleen
dc.subjecterythromycinen
dc.subjectfosfomycinen
dc.subjectfusidic aciden
dc.subjectgentamicinen
dc.subjectleukocidinen
dc.subjectlincosamideen
dc.subjectmacrolideen
dc.subjectnitrofurantoinen
dc.subjectoxacillinen
dc.subjectPanton Valentine leukocidinen
dc.subjectpenicillin derivativeen
dc.subjectpseudomonic aciden
dc.subjectrifampicinen
dc.subjectteicoplaninen
dc.subjecttetracyclineen
dc.subjecttimentinen
dc.subjecttobramycinen
dc.subjectvancomycinen
dc.subjectantiinfective agenten
dc.subjectbacterial toxinen
dc.subjectexotoxinen
dc.subjectmeticillinen
dc.subjectPanton-Valentine leukocidinen
dc.subjectpseudomonic aciden
dc.subjectantibiotic resistanceen
dc.subjectantibiotic sensitivityen
dc.subjectantimicrobial therapyen
dc.subjectArticleen
dc.subjectbacteremiaen
dc.subjectbacterial geneen
dc.subjectbacterial virulenceen
dc.subjectbacterium isolateen
dc.subjectdisk diffusionen
dc.subjectDNA extractionen
dc.subjectgene frequencyen
dc.subjectgene locusen
dc.subjectgene sequenceen
dc.subjectGreeceen
dc.subjecthumanen
dc.subjectinhibitory concentrationen
dc.subjectmethicillin susceptible Staphylococcus aureusen
dc.subjectminimum inhibitory concentrationen
dc.subjectmolecular epidemiologyen
dc.subjectmolecular typingen
dc.subjectmotor unit potentialen
dc.subjectmultilocus sequence typingen
dc.subjectnonhumanen
dc.subjectpenicillin resistanceen
dc.subjectphylogenetic treeen
dc.subjectpolymerase chain reactionen
dc.subjectpulsed field gel electrophoresisen
dc.subjectserotypingen
dc.subjectskin infectionen
dc.subjectsoft tissue infectionen
dc.subjectStaphylococcus aureusen
dc.subjecttertiary care centeren
dc.subjectadulten
dc.subjectdrug effecten
dc.subjectgeneticsen
dc.subjectGreeceen
dc.subjectisolation and purificationen
dc.subjectmicrobiologyen
dc.subjectsoft tissue infectionen
dc.subjectstaphylococcal skin infectionen
dc.subjectStaphylococcus infectionen
dc.subjectAdulten
dc.subjectAnti-Bacterial Agentsen
dc.subjectBacterial Toxinsen
dc.subjectExotoxinsen
dc.subjectGenes, Bacterialen
dc.subjectGreeceen
dc.subjectHumansen
dc.subjectLeukocidinsen
dc.subjectMethicillinen
dc.subjectMultilocus Sequence Typingen
dc.subjectMupirocinen
dc.subjectSoft Tissue Infectionsen
dc.subjectStaphylococcal Infectionsen
dc.subjectStaphylococcal Skin Infectionsen
dc.subjectStaphylococcus aureusen
dc.subjectBioMed Central Ltden
dc.titleEmergence of a mupirocin-resistant, methicillin-susceptible Staphylococcus aureus clone associated with skin and soft tissue infections in Greeceen
dc.typejournalArticleen


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