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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Emergence of Methicillin-Resistant Staphylococcus aureus ST239/241 SCCmec-III Mercury in Eastern Algeria
Hanane Aouati1,2,3, Linda Hadjadj2, Farida Aouati4
1Département de Microbiologie, Faculté des Sciences de la Nature et de la Vie, Université des Frères Mentouri Constantine 1, Constantine 25017, Algeria.
Abstract:
In this paper, we investigate the epidemiology of infections-associated Staphylococcusaureus (S. aureus) from the Medical Intensive Care Unit (MICU) at University Hospital Center of Constantine (UHCC) in Algeria, with a special emphasis on methicillin-resistant strains (MRSA) revealed by cefoxitin disks (30 μg), then confirmed by penicillin-binding protein (PBP2a) agglutination and real-time polymerase chain reaction (RT-PCR) targeting mecA and mecC genes. Staphylococcal Cassette Chromosome mec (SCCmec type), staphylococcal protein A (spa-type), multilocus sequence type (MLST), Panton-Valentine Leucocidin (PVL), and toxic shock syndrome toxin-1 (TSST-1) were further investigated in all isolates, and whole genome sequencing was performed for a selected subset of three hospital-acquired MRSA (HA-MRSA) isolates. A measurement of 80% out of the 50 S. aureus isolates were identified as HA-MRSA harbouring the mecA gene, and 72.5% of them were multidrug resistant (MDR). Twelve STs, four different SCCmec cassettes, fourteen spa types, ten isolates Panton-Valentine Leukocidin (PVL)-positive, and three isolates TSST-1 were identified. Interestingly, there was a high prevalence (n = 29; 72.5%) of a worrisome emerging clone: the HA-MRSA ST239/241 SCCmec-III mercury with PVL negative, resistant to β-lactams, aminoglycosides, quinolones, and tetracyclines. Other clones of HA-MRSA isolates were also identified, including PVL-positive ST80 SCCmec-IV/SCCmec-unknown (22.5%), ST34 SCCmec-V with TSST-1 positive (2.5%), and PVL-negative ST72 SCCmec-II (2.5%). Genome analysis enables us to describe the first detection of both PVL-negative HA-MRSA ST239/241 SCCmec-III mercury carrying ccrC, as well as SCCmec-V cassette, which dramatically changes the epidemiology of S. aureus infections in one of the hospitals in eastern Algeria.
Insights
This study identified a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in an Algerian ICU, with a concerning emerging clone (ST239/241) showing multidrug resistance. The findings highlight a significant shift in S. aureus infection epidemiology in the region.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Staphylococcus aureus (S. aureus) infections, particularly methicillin-resistant strains (MRSA), pose a significant threat in healthcare settings.
- Understanding the epidemiology and genetic characteristics of S. aureus, including MRSA, is crucial for effective infection control.
- The Medical Intensive Care Unit (MICU) of the University Hospital Center of Constantine (UHCC) in Algeria is a key area for investigating local S. aureus epidemiology.
Purpose of the Study:
- To investigate the epidemiology of S. aureus infections in the MICU at UHCC, Algeria.
- To characterize methicillin-resistant S. aureus (MRSA) strains, focusing on resistance mechanisms and genetic profiles.
- To identify emerging MRSA clones and their epidemiological impact in eastern Algeria.
Main Methods:
- Isolation and identification of S. aureus from clinical samples.
- Detection of MRSA using cefoxitin disks, confirmed by PBP2a agglutination and RT-PCR for mecA/mecC genes.
- Molecular typing including SCCmec typing, spa-typing, MLST, and detection of PVL and TSST-1.
- Whole genome sequencing of selected HA-MRSA isolates.
Main Results:
- 80% of 50 S. aureus isolates were identified as hospital-acquired MRSA (HA-MRSA) carrying the mecA gene.
- 72.5% of HA-MRSA isolates were multidrug resistant (MDR).
- A prevalent emerging clone, HA-MRSA ST239/241 SCCmec-III mercury (PVL-negative), was identified in 72.5% of MRSA isolates.
- Other HA-MRSA clones included ST80 (PVL-positive), ST34 (TSST-1 positive), and ST72 (PVL-negative).
- Genome analysis revealed the first detection of PVL-negative HA-MRSA ST239/241 SCCmec-III mercury with ccrC and SCCmec-V cassettes in Algeria.
Conclusions:
- This study reveals a high burden of HA-MRSA and MDR strains in the MICU of UHCC, Algeria.
- The emergence of the ST239/241 clone significantly alters the S. aureus infection landscape in eastern Algeria.
- The findings underscore the need for enhanced surveillance and infection control strategies targeting specific MRSA clones.
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