A Prospective Cohort Multicenter Study of Molecular Epidemiology and Phylogenonnics of Staphylococcus aureus Bacterennia in Nine Latin American Countries

作者：Arias Cesar A^*; Reyes Jinnethe; Paola Carvajal Lina; Rincon Sandra; Diaz Lorena; Panesso Diana; Lbarra Gabriel; Rios Rafael; Munita Jose M; Salles Mauro J; Alvarez Moreno Carlos; Labarca Jaime; Garcia Coralith; Luna Carlos M; Mejia Villatoro Carlos; Zurita Jeannete; Guzman Blanco Manuel; Rodriguez Noriega Eduardo; Narechania Apurva; Rojas Laura J; Planet Paul J; Weinstock George M; Gotuzzo Eduardo; Seas Carlos

来源：Antimicrobial Agents and Chemotherapy, 2017, 61(10): e00816-17.

DOI：10.1128/AAC.00816-17

• bacteremia
• Latin America
• Staphylococcus aureus

Staphylococcus aureus is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant S. aureus (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 S. aureus) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette mec [SCCmed I and II). Clade B included ST8, 5T88, ST97, and ST72 strains (SCCmec IV, subtypes a, b, and c/E), and dade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA.

• 出版日期2017-10
• 单位河北医科大学