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Detection, spread and phylogeny of meticillin-resistant Staphylococcus aureus sequence type 45 in Taiwan
Yhu-Chering Huang1,2, Chih-Jung Chen1,2, Tsai-Ling Yang Lauderdale3
1Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital at Linkou, Kweishan, Taoyuan, Taiwan, Taiwan, ROC.
Abstract:
Meticillin-resistant Staphylococcus aureus (MRSA) sequence type (ST) 45 was reported in the literature to have been first identified in 2006 in Taiwan. The present study was carried out to explore and trace the emergence, transmission and evolutional dynamics of MRSA ST45 in Taiwan. We identified MRSA ST45 isolates retrospectively from two collections of MRSA isolates, namely TSAR (Taiwan Surveillance of Antimicrobial Resistance) surveys and the CGMH (Chang Gung Memorial Hospital)-based laboratory collection. Representative ST45 isolates were selected for whole-genome sequencing (WGS) analysis. A total of 9554 MRSA isolates was included in this study. Among the 3766 MRSA isolates biennially collected from TSAR surveys between 1998 and 2014, ST45 accounted for 133 (3.53 %) MRSA isolates, was first identified in 2004, and the prevalence rate peaked in 2010 (up to 10.77 %). Among the 5788 MRSA isolates collected between 1995 and 2017 by the CGMH-based laboratory, 257 isolates (4.44 %) were characterized as ST45, with most identified from nursing homes since 2012. Of the 75 isolates randomly selected for WGS, two clades were identified. The major clade, clade II, comprised 63 isolates and was phylogenetically relatively close to those isolates identified from Singapore. All but one of the isolates in clade I, the minor clade, were identified from non-Taiwanese people, mostly from newly recruited foreign workers in 2017, and were phylogenetically relatively close to one isolate from the USA (CA-347). Conclusively, the emergence of MRSA ST45 strain in Taiwan can be traced back to 2004 and the strain is connected to South-East Asian countries. Since its emergence, transmission and spread of MRSA ST45 has occurred in Taiwan.
Insights
Meticillin-resistant Staphylococcus aureus (MRSA) ST45 emerged in Taiwan in 2004, linked to Southeast Asia. This study traces its transmission and evolution within Taiwan, revealing spread in healthcare and community settings.
Area of Science:
- Microbiology
- Epidemiology
- Genomics
Background:
- Meticillin-resistant Staphylococcus aureus (MRSA) sequence type (ST) 45 was previously reported in Taiwan.
- Understanding the emergence and spread of specific MRSA strains is crucial for public health.
Purpose of the Study:
- To investigate the emergence, transmission, and evolutionary dynamics of MRSA ST45 in Taiwan.
- To trace the origins and spread of MRSA ST45 using genomic data.
Main Methods:
- Retrospective analysis of MRSA isolates from TSAR surveys and CGMH laboratory collections.
- Whole-genome sequencing (WGS) of selected MRSA ST45 isolates.
- Phylogenetic analysis to determine relationships between isolates.
Main Results:
- MRSA ST45 was first identified in Taiwan in 2004, predating previous reports.
- Prevalence peaked in 2010, with significant identification in nursing homes since 2012.
- WGS revealed two clades; clade II was similar to Singaporean isolates, and clade I was linked to foreign workers and a US isolate.
Conclusions:
- MRSA ST45 emerged in Taiwan in 2004, with connections to Southeast Asian countries.
- The strain has since transmitted and spread within Taiwan.
- Genomic analysis provides insights into the introduction and diversification of MRSA ST45.
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