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Volume 59, Issue 7

Epidemic meticillin-resistant (EMRSA-15) variants detected in healthy and diseased individuals in India Free

Abstract

This study provides what we believe to be the first report of the presence of EMRSA-15 and its variants isolated from nasal swabs from 13 healthy and diseased individuals in India. The majority of the isolates belonged to staphylococcal cassette chromosome (SCC) type IV and type t852, whilst four isolates were non-typable and heterotypic for the presence of the gene. All non-typable isolates were positive for the gene by PCR and belonged to types t005 and t2986. They may have variant SCC cassettes indicating genetic changes occurring in the Indian EMRSA-15. All isolates were positive for Panton–Valentine leukocidin and toxic shock syndrome toxin, which is a cause for concern. In addition to soft-tissue infections, the EMRSA-15 isolates from patients were also responsible for meningitis and brain abscesses, which is quite rare.

  • Received:
  • Accepted:
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Keyword(s): CA, community-acquired , EMRSA, epidemic MRSA strain , HA, hospital-associated , MLST, multilocus sequence typing , MRSA, meticillin-resistant S. aureus , MSSA, meticillin-sensitive S. aureus , PVL, Panton–Valentine leukocidin , SCCmec, staphylococcal cassette chromosome mec and ST, sequence type
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2010-07-01
2024-04-20
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References

  1. Aires-de-Sousa M., Correia B., de Lencastre H. Multilaboratory Project Collaborators 2008; Changing patterns in frequency of recovery of five methicillin-resistant Staphylococcus aureus clones in Portuguese hospitals: surveillance over a 16-year period. J Clin Microbiol 46:2912–2919 [CrossRef]
     [Google Scholar]
  2. Amorim M. L., Faria N. A., Oliveira D. C., Vasconcelos C., Cabeda J. C., Mendes A. C., Calado E., Castro A. P., Ramos M. H. other authors 2007; Changes in the clonal nature and antibiotic resistance profiles of methicillin-resistant Staphylococcus aureus isolates associated with spread of the EMRSA-15 clone in a tertiary care Portuguese hospital. J Clin Microbiol 45:2881–2889 [CrossRef]
     [Google Scholar]
  3. Arakere G., Nadig S., Swedberg G., Macaden R., Amarnath S., Raghunath D. 2005; Genotyping of methicillin resistant Staphylococcus aureus strains from two hospitals in Bangalore, South India. J Clin Microbiol 43:3198–3202 [CrossRef]
     [Google Scholar]
  4. Broekema N. M., Van T. T., Monson T. A., Marshall S. A., Warshauer D. M. 2009; Comparison of cefoxitin and oxacillin disk diffusion methods for detection of mecA -mediated resistance in Staphylococcus aureus in a large-scale study. J Clin Microbiol 47:217–219 [CrossRef]
     [Google Scholar]
  5. Chambers H. F. 2005; Community-associated MRSA – resistance and virulence converge. N Engl J Med 352:1485–1487 [CrossRef]
     [Google Scholar]
  6. Chambers H. F., DeLeo F. R. 2009; Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol 7:629–641 [CrossRef]
     [Google Scholar]
  7. CLSI 2009; Performance Standards for Antimicrobial Susceptibility Testing, 19th Informational Supplement. M100-S19 Wayne, PA: Clinical and Laboratory Standards Institute;
  8. Cockfield J. D., Pathak S., Edgeworth J. D., Lindsay J. A. 2007; Rapid determination of hospital-acquired meticillin-resistant Staphylococcus aureus lineages. J Med Microbiol 56:614–619 [CrossRef]
     [Google Scholar]
  9. Enright M. C., Day N. P. J., Davies C. E., Peacock S. J., Spratt B. G. 2000; Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus . J Clin Microbiol 38:1008–1015
     [Google Scholar]
  10. Feng Y., Chen C., Su L., Hu S., Yu J., Chiu C. 2008; Evolution and pathogenesis of Staphylococcus aureus : lessons learned from genotyping and comparative genomics. FEMS Microbiol Rev 32:23–37 [CrossRef]
     [Google Scholar]
  11. Ghebremedhin B., König W., Witte W., Hardy K. J., Hawkey P. M., König B. 2007; Subtyping of ST22-MRSA-IV (Barnim epidemic MRSA strain) at a university clinic in Germany from 2002 to 2005. J Med Microbiol 56:365–375 [CrossRef]
     [Google Scholar]
  12. Gilot P., Lina G., Cochard T., Poutrel B. 2002; Analysis of the genetic variability of genes encoding the RNA III-activating components Agric and TRAP in a population of Staphylococcus aureus strains isolated from cows with mastitis. J Clin Microbiol 40:4060–4067 [CrossRef]
     [Google Scholar]
  13. Gordon R. J., Lowy F. D. 2008; Pathogenesis of methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis 46:S350–S359 [CrossRef]
     [Google Scholar]
  14. Holmes A., Ganner M., McGuane S., Pitt T. L., Cookson B. D., Kearns A. M. 2005; Staphylococcus aureus isolates carrying Panton–Valentine leucocidin genes in England and Wales: frequency, characterization, and association with clinical disease. J Clin Microbiol 43:2384–2390 [CrossRef]
     [Google Scholar]
  15. Hsu L.-Y., Loomba-Chlebicka N., Koh Y.-L., Tan T.-Y., Krishnan P., Lin R. T.-P., Tee N. W.-S., Fisher D. A., Koh T.-H. 2007; Evolving EMRSA-15 epidemic in Singapore hospitals. J Med Microbiol 56:376–379 [CrossRef]
     [Google Scholar]
  16. Huletsky A., Giroux R., Rossbach V., Gagnon M., Vaillancourt M., Bernier M., Gagnon F., Truchon K., Bastien M. other authors 2004; New real time PCR assay for rapid detection of MRSA directly from specimens containing a mixture of staphylococci. J Clin Microbiol 42:1875–1884 [CrossRef]
     [Google Scholar]
  17. International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements 2009; Classification of staphylococcal cassette chromosome mec (SCC mec ): guidelines for reporting novel SCC mec elements. Antimicrob Agents Chemother 53:4961–4967 [CrossRef]
     [Google Scholar]
  18. Ito T., Katayama Y., Asada K., Mori N., Tsutsumimoto K., Tiensasitorn C., Hiramatsu K. 2001; Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 45:1323–1336 [CrossRef]
     [Google Scholar]
  19. Kondo Y., Ito T., Ma X. X., Watanabe S., Kreiswirth B. N., Etienne J., Hiramatsu K. 2007; Combination of multiplex PCRs for staphylococcal cassette chromosome mec type assignment: rapid identification system for mec , ccr , and major differences in junkyard regions. Antimicrob Agents Chemother 51:264–274 [CrossRef]
     [Google Scholar]
  20. Krishna B. V. S., Patil A. B., Chandrasekhar M. R. 2004; Community-acquired methicillin-resistant Staphylococcus aureus infections in a south Indian city. Southeast Asian J Trop Med Public Health 35:371–374
     [Google Scholar]
  21. Labandeira-Rey M., Couzon F., Boisset S., Brown E. L., Bes M., Benito Y., Barbu E. M., Vasquez V., Höök M. other authors 2007; Staphylococcus aureus Panton–Valentine leukocidin causes necrotizing pneumonia. Science 315:1130–1133 [CrossRef]
     [Google Scholar]
  22. Larsen A. R., Goering R., Stegger M., Lindsay J. A., Gould K. A., Hinds J., Sørum M., Westh H., Boye K., Skov R. 2009; Two distinct clones of MRSA with the same USA300 PFGE profile – a potential pitfall for identification of USA300 CA-MRSA. J Clin Microbiol 47:3765–3768 [CrossRef]
     [Google Scholar]
  23. Lina G., Piemont Y., Godail-Gamot F., Bes M., Peter M. O., Gauduchon V., Vandenesch F., Etienne J. 1999; Involvement of Panton–Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 29:1128–1132 [CrossRef]
     [Google Scholar]
  24. Llarrull L. I., Fisher J. F., Mobashery S. 2009; Molecular basis and phenotype of methicillin resistance in Staphylococcus aureus and insights into new β -lactams that meet the challenge. Antimicrob Agents Chemother 53:4051–4063 [CrossRef]
     [Google Scholar]
  25. Löffler B., Hussain M., Grundmeier M., Brück M., Holzinger D., Varga G., Roth J., Kahl B. C., Proctor R. A., Peters G. 2010; Staphylococcus aureus Panton–Valentine leukocidin is a very potent cytotoxic factor for human neutrophils. PLoS Pathog 6:e1000715 [CrossRef]
     [Google Scholar]
  26. Mehrotra M., Wang G., Johnson W. M. 2000; Multiplex PCR for detection of genes for Staphylococcus aureus enterotoxins, exfoliative toxins, toxic shock syndrome toxin 1, and methicillin resistance. J Clin Microbiol 38:1032–1035
     [Google Scholar]
  27. Melter O., Urbaskova P., Jakubu V., Mackova B., Zemlickova H. 2006; Emergence of EMRSA-15 clone in hospitals throughout the Czech Republic. Euro Surveill 11:E060803–E060806
     [Google Scholar]
  28. Milheirico C., Oliveira D. C., de Lencastre H. 2007; Update to the multiplex PCR strategy for the assignment of mec element types in Staphylococcus aureus . Antimicrob Agents Chemother 51:3374–3377 [CrossRef]
     [Google Scholar]
  29. Moore P. C., Lindsay J. A. 2002; Molecular characterisation of the dominant UK methicillin-resistant Staphylococcus aureus strains, EMRSA-15 and EMRSA-16. J Med Microbiol 51:516–521
     [Google Scholar]
  30. Nadig S., Namburi P., Raghunath D., Arakere G. 2006; Genotyping of methicillin-resistant Staphylococcus aureus isolates from Indian hospitals. Curr Sci 91:1364–1369
     [Google Scholar]
  31. Naesens R., Ronsyn M., Druwé P., Denis O., Ieven M., Jeurissen A. 2009; Central nervous system invasion by community-acquired meticillin-resistant Staphylococcus aureus . J Med Microbiol 58:1247–1251 [CrossRef]
     [Google Scholar]
  32. Okuma K., Iwakawa K., Turnidge J. D., Grubb W. B., Bell J. M., O'Brien F. G., Coombs G. W., Pearman J. W., Tenover F. C. other authors 2002; Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J Clin Microbiol 40:4289–4294 [CrossRef]
     [Google Scholar]
  33. Oliveira D. C., de Lencastre H. 2002; Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus . Antimicrob Agents Chemother 46:2155–2161 [CrossRef]
     [Google Scholar]
  34. O'Neill G. L., Murchan S., Gil-Setas A., Aucken H. M. 2001; Identification and characterization of phage variants of a strain of epidemic methicillin-resistant Staphylococcus aureus (EMRSA-15. J Clin Microbiol 39:1540–1548 [CrossRef]
     [Google Scholar]
  35. Popovich K. J., Weinstein R. A., Hota B. 2008; Are community-associated methicillin-resistant Staphylococcus aureus (MRSA) strains replacing traditional nosocomial MRSA strains?. Clin Infect Dis 46:787–794 [CrossRef]
     [Google Scholar]
  36. Shibuya Y., Hara M., Higuchi W., Takano T., Iwao Y., Yamamoto T. 2008; Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA300 clone in Japan. J Infect Chemother 14:439–441 [CrossRef]
     [Google Scholar]
  37. Shopsin B., Gomez M., Montgomery S. O., Smith D. H., Waddington M., Dodge D. E., Bost D. A., Riehman M., Naidich S., Kreiswirth B. N. 1999; Evaluation of protein A gene polymorphic region DNA sequencing for typing of Staphylococcus aureus strains. J Clin Microbiol 37:3556–3563
     [Google Scholar]
  38. Tenover F. C., Goering R. V. 2009; Methicillin-resistant Staphylococcus aureus strain USA300: origin and epidemiology. J Antimicrob Chemother 64:441–446 [CrossRef]
     [Google Scholar]
  39. Udo E. E., Al-Sweih N., Noronha B. 2006; Characterisation of non-multiresistant methicillin-resistant Staphylococcus aureus (including EMRSA-15) in Kuwait hospitals. Clin Microbiol Infect 12:262–269 [CrossRef]
     [Google Scholar]
  40. Veenakumari H. B., Nagaraja D., Nagarathna S., Kulkarni G. B., Praveen C. S., Nadig S., Arakere G. 2010; A variant epidemic meticillin resistant Staphylococcus aureus -15 (EMRSA-15) CST with meningitis – a rare occurrence with unusual presentation. Indian J Med Microbiol in press
    [Google Scholar]
  41. Vindel A., Cuevas O., Cercenado E., Marcos C., Bautista V., Castellares C., Trincado P., Boquete T., Pérez-Vázquez M. other authors 2009; Methicillin-resistant Staphylococcus aureus in Spain: molecular epidemiology and utility of different typing methods. J Clin Microbiol 47:1620–1627 [CrossRef]
     [Google Scholar]
  42. Voyich J. M., Otto M., Mathema B., Braughton K. R., Whitney A. R., Welty D., Long R. D., Dorward D. W., Gardner D. J. other authors 2006; Is Panton–Valentine leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease?. J Infect Dis 194:1761–1770 [CrossRef]
     [Google Scholar]
  43. Wannet W. 2003; Virulent MRSA strains containing the Panton Valentine leukocidin gene in the Netherlands. Euro Surveill 7:2173
     [Google Scholar]
  44. Wolter D. J., Chatterjee A., Varman M., Goering R. V. 2008; Isolation and characterization of an epidemic methicillin-resistant Staphylococcus aureus 15 variant in the central United States. J Clin Microbiol 46:3548–3549 [CrossRef]
     [Google Scholar]
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Epidemic meticillin-resistant Staphylococcus aureus (EMRSA-15) variants detected in healthy and diseased individuals in India
J. Med. Microbiol. 59, 815 (2010); https://doi.org/10.1099/jmm.0.017632-0
/content/journal/jmm/10.1099/jmm.0.017632-0
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