Session Type: ePosters
Session Title: ePosters
Authors(s): H. Fenyvesi (1), K. Kovács (1), R. Meszéna (1), P. Urbán (2), A. Gyenesei (2), T. Pál (1), Á. Sonnevend (1)
Authors Affiliations(s): (1) University of Pécs Medical School, Hungary, (2) University of Pécs Szentágothai Research Center, Hungary
Background:
Although methicillin resistant Staphylococcus aureus (MRSA) was reported to cause skin and soft tissue infections (SSTI) worldwide, no molecular details of such isolates allowing international comparison have recently been available from Hungary. We aimed to characterize by whole-genome sequencing (WGS) MRSA isolated from wounds in a tertiary-care hospital.
Methods:MRSA, identified by MALDI-TOF MS and cefoxitin disc screening, isolated from wounds between 2019 October and 2020 April were subjected to WGS by Illumina MiSeq 250bp paired-end sequencing. Resistance, virulence gene content and core genome MLST was assessed using Ridom SeqShere+. Phenotypic susceptibility was tested. Patients’ notes were reviewed for data on previous hospitalisation and length of hospital stay.
Results:During the study period 14.5% of non-repeat S. aureus wound isolates were MRSA. Of these 21 were available for WGS. While most of these isolates remained susceptible to aminoglycosides, trimethoprim-sulphamethoxazole and ceftaroline, the majority were resistant to fluoroquinolones, clindamycin and erythromycin (76%, 81% and 81%, respectively). They were uniformly susceptible to rifampicin and vancomycin. Molecular typing identified seven ST225-MRSA-II, seven CC22-MRSA-IV, two ST45-MRSA-IV and ST1-MRSA with type V and IX composite SCCmec, ST1-MRSA-IV, ST228-MRSA-I, ST398-MRSA-V and ST923-MRSA-IV represented by one isolate each. ermA or ermC genes were carried by 76% of MRSA isolates, corresponding to the high rate of MLSB resistance phenotype observed. The strains possessed various hemolysin, enterotoxin and leukotoxin coding genes with the notable absence of tst-1. Only two isolates, the ST1-MRSA-V-IX and the ST923-MRSA-IV carried the lukSF-PVL genes. cgMLST revealed three clusters: one group of four CC22-MRSA-IV, a triplet and a pair of ST225-MRSA-II, respectively. The clusters were not associated with any hospital wards. Only tree isolates (an ST225-MRSA-II, an ST1-MRSA-IV and an ST923-MRSA-IV) were from patients without prior hospitalisation of the preceding year or longer than 48h hospital stay during the current admission.
Conclusions:Although obvious clustering of MRSA wound isolates during the study period could not be demonstrated, the majority of MRSA were hospital-acquired types and the SSTI occurred in patients with previous healthcare exposure. Nevertheless, the first isolation of a community acquired PVL positive ST923-MRSA-IV, a close relative of the USA300 ST8-MRSA-IV, in Hungary warrants further attention.
Keyword(s): Skin and soft tissue infection, CA-MRSA, HungarySession Type: ePosters
Session Title: ePosters
Authors(s): H. Fenyvesi (1), K. Kovács (1), R. Meszéna (1), P. Urbán (2), A. Gyenesei (2), T. Pál (1), Á. Sonnevend (1)
Authors Affiliations(s): (1) University of Pécs Medical School, Hungary, (2) University of Pécs Szentágothai Research Center, Hungary
Background:
Although methicillin resistant Staphylococcus aureus (MRSA) was reported to cause skin and soft tissue infections (SSTI) worldwide, no molecular details of such isolates allowing international comparison have recently been available from Hungary. We aimed to characterize by whole-genome sequencing (WGS) MRSA isolated from wounds in a tertiary-care hospital.
Methods:MRSA, identified by MALDI-TOF MS and cefoxitin disc screening, isolated from wounds between 2019 October and 2020 April were subjected to WGS by Illumina MiSeq 250bp paired-end sequencing. Resistance, virulence gene content and core genome MLST was assessed using Ridom SeqShere+. Phenotypic susceptibility was tested. Patients’ notes were reviewed for data on previous hospitalisation and length of hospital stay.
Results:During the study period 14.5% of non-repeat S. aureus wound isolates were MRSA. Of these 21 were available for WGS. While most of these isolates remained susceptible to aminoglycosides, trimethoprim-sulphamethoxazole and ceftaroline, the majority were resistant to fluoroquinolones, clindamycin and erythromycin (76%, 81% and 81%, respectively). They were uniformly susceptible to rifampicin and vancomycin. Molecular typing identified seven ST225-MRSA-II, seven CC22-MRSA-IV, two ST45-MRSA-IV and ST1-MRSA with type V and IX composite SCCmec, ST1-MRSA-IV, ST228-MRSA-I, ST398-MRSA-V and ST923-MRSA-IV represented by one isolate each. ermA or ermC genes were carried by 76% of MRSA isolates, corresponding to the high rate of MLSB resistance phenotype observed. The strains possessed various hemolysin, enterotoxin and leukotoxin coding genes with the notable absence of tst-1. Only two isolates, the ST1-MRSA-V-IX and the ST923-MRSA-IV carried the lukSF-PVL genes. cgMLST revealed three clusters: one group of four CC22-MRSA-IV, a triplet and a pair of ST225-MRSA-II, respectively. The clusters were not associated with any hospital wards. Only tree isolates (an ST225-MRSA-II, an ST1-MRSA-IV and an ST923-MRSA-IV) were from patients without prior hospitalisation of the preceding year or longer than 48h hospital stay during the current admission.
Conclusions:Although obvious clustering of MRSA wound isolates during the study period could not be demonstrated, the majority of MRSA were hospital-acquired types and the SSTI occurred in patients with previous healthcare exposure. Nevertheless, the first isolation of a community acquired PVL positive ST923-MRSA-IV, a close relative of the USA300 ST8-MRSA-IV, in Hungary warrants further attention.
Keyword(s): Skin and soft tissue infection, CA-MRSA, Hungary