High genetic diversity among community-associated Staphylococcus aureus in Europe: results from a multicenter study

Joana Rolo, Maria Miragaia, Turlej-Rogacka, Agata, Joanna Empel, O. Bouchami, N.A. Faria, A. Tavares , Waleria Hryniewicz, Fluit, Ad C.

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND:
Several studies have addressed the epidemiology of community-associated Staphylococcus aureus (CA-SA) in Europe; nonetheless, a comprehensive perspective remains unclear. In this study, we aimed to describe the population structure of CA-SA and to shed light on the origin of methicillin-resistant S. aureus (MRSA) in this continent.

METHODS AND FINDINGS:
A total of 568 colonization and infection isolates, comprising both MRSA and methicillin-susceptible S. aureus (MSSA), were recovered in 16 European countries, from community and community-onset infections. The genetic background of isolates was characterized by molecular typing techniques (spa typing, pulsed-field gel electrophoresis and multilocus sequence typing) and the presence of PVL and ACME was tested by PCR. MRSA were further characterized by SCCmec typing. We found that 59% of all isolates were associated with community-associated clones. Most MRSA were related with USA300 (ST8-IVa and variants) (40%), followed by the European clone (ST80-IVc and derivatives) (28%) and the Taiwan clone (ST59-IVa and related clonal types) (15%). A total of 83% of MRSA carried Panton-Valentine leukocidin (PVL) and 14% carried the arginine catabolic mobile element (ACME). Surprisingly, we found a high genetic diversity among MRSA clonal types (ST-SCCmec), Simpson's index of diversity = 0.852 (0.788-0.916). Specifically, about half of the isolates carried novel associations between genetic background and SCCmec. Analysis by BURP showed that some CA-MSSA and CA-MRSA isolates were highly related, suggesting a probable local acquisition/loss of SCCmec.

CONCLUSIONS:
Our results imply that CA-MRSA origin, epidemiology and population structure in Europe is very dissimilar from that of USA.
Original languageEnglish
Pages (from-to)e34768-34778
Number of pages10
JournalPLoS ONE
VolumeVol. 7
Issue numbern.º 4
DOIs
Publication statusPublished - 27 Apr 2012

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