Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection

Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality, which varies depending on the source of infection. Nevertheless, the global molecular epidemiology of SAB and its possible association with specific virulence factors remains unclear. Using DNA microarrays, a tot...

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Autores: Perez-Montarelo, Dame; Viedma, Esther; Larrosa, Nieves; Gomez-Gonzalez, Carmen; Ruiz de Gopegui-Bordes, Enrique; Munoz-Gallego, Irene; San Juan, Rafael; Fernandez-Hidalgo, Nuria; Aimirante, Benito; Chaves, Fernando
Tipo de documento: Artículo
Fecha de publicación:2018
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Lenguaje:Inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/22568
Acceso en línea:https://hdl.handle.net/20.500.12105/22568
Nivel de acceso:Acceso abierto
Palabra clave:Staphylococcus aureus bacteremia
Bacteremia source
Molecular epidemiology
Clonal complex
Virulence factors
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author Perez-Montarelo, Dame
author2 Viedma, Esther
Larrosa, Nieves
Gomez-Gonzalez, Carmen
Ruiz de Gopegui-Bordes, Enrique
Munoz-Gallego, Irene
San Juan, Rafael
Fernandez-Hidalgo, Nuria
Aimirante, Benito
Chaves, Fernando
author2_role author
author
author
author
author
author
author
author
author
author_browse Aimirante, Benito
Chaves, Fernando
Fernandez-Hidalgo, Nuria
Gomez-Gonzalez, Carmen
Larrosa, Nieves
Munoz-Gallego, Irene
Perez-Montarelo, Dame
Ruiz de Gopegui-Bordes, Enrique
San Juan, Rafael
Viedma, Esther
author_facet Perez-Montarelo, Dame
Viedma, Esther
Larrosa, Nieves
Gomez-Gonzalez, Carmen
Ruiz de Gopegui-Bordes, Enrique
Munoz-Gallego, Irene
San Juan, Rafael
Fernandez-Hidalgo, Nuria
Aimirante, Benito
Chaves, Fernando
author_role author
collection Repisalud
description Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality, which varies depending on the source of infection. Nevertheless, the global molecular epidemiology of SAB and its possible association with specific virulence factors remains unclear. Using DNA microarrays, a total of 833 S. aureus strains (785 SAB and 48 colonizing strains) collected in Spain over a period of 15 years (2002-2017) were characterized to determine clonal complex (CC), agr type and repertoire of resistance and virulence genes in order to provide an epidemiological overview of CCs causing bloodstream infection, and to analyze possible associations between virulence genes and the most common sources of bacteremia. The results were also analyzed by acquisition (healthcare-associated [HA] and community-acquired [CA]), methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) strains, and patient age (adults vs. children). Our results revealed high clonal diversity among SAB strains with up to 28 different CCs. The most prevalent CCs were CC5 (30.8%), CC30 (20.3%), CC45 (8.3%), CC8 (8.4%), CC15 (7.5%), and CC22 (5.9%), which together accounted for 80% of all cases. A higher proportion of CC5 was found among HA strains than CA strains (35.6 vs. 20.2%, p < 0.001). CC5 was associated with methicillin resistance (14.7 vs. 79.4%, p < 0.001), whereas CC30, CC45, and CC15 were correlated with MSSA strains (p < 0.001). Pathogen-related molecular markers significantly associated with a specific source of bacteremia included the presence of sea, undisrupted hlb and isaB genes with catheter-related bacteremia; sed, splE, and fib genes with endocarditis; undisrupted hlb with skin and soft tissue infections; and finally, CC5, msrA resistance gene and hla gene with osteoarticular source. Our study suggests an association between S. aureus genotype and place of acquisition, methicillin resistance and sources of bloodstream infection, and provides a valuable starting point for further research insights into intrinsic pathogenic mechanisms involved in the development of SAB.
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instname_str Instituto de Salud Carlos III (ISCIII)
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publishDate 2018
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spelling Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection Perez-Montarelo, Dame Viedma, Esther Larrosa, Nieves Gomez-Gonzalez, Carmen Ruiz de Gopegui-Bordes, Enrique Munoz-Gallego, Irene San Juan, Rafael Fernandez-Hidalgo, Nuria Aimirante, Benito Chaves, Fernando Staphylococcus aureus bacteremia Bacteremia source Molecular epidemiology Clonal complex Virulence factors Staphylococcus aureus bacteremia (SAB) is associated with high morbidity and mortality, which varies depending on the source of infection. Nevertheless, the global molecular epidemiology of SAB and its possible association with specific virulence factors remains unclear. Using DNA microarrays, a total of 833 S. aureus strains (785 SAB and 48 colonizing strains) collected in Spain over a period of 15 years (2002-2017) were characterized to determine clonal complex (CC), agr type and repertoire of resistance and virulence genes in order to provide an epidemiological overview of CCs causing bloodstream infection, and to analyze possible associations between virulence genes and the most common sources of bacteremia. The results were also analyzed by acquisition (healthcare-associated [HA] and community-acquired [CA]), methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) strains, and patient age (adults vs. children). Our results revealed high clonal diversity among SAB strains with up to 28 different CCs. The most prevalent CCs were CC5 (30.8%), CC30 (20.3%), CC45 (8.3%), CC8 (8.4%), CC15 (7.5%), and CC22 (5.9%), which together accounted for 80% of all cases. A higher proportion of CC5 was found among HA strains than CA strains (35.6 vs. 20.2%, p < 0.001). CC5 was associated with methicillin resistance (14.7 vs. 79.4%, p < 0.001), whereas CC30, CC45, and CC15 were correlated with MSSA strains (p < 0.001). Pathogen-related molecular markers significantly associated with a specific source of bacteremia included the presence of sea, undisrupted hlb and isaB genes with catheter-related bacteremia; sed, splE, and fib genes with endocarditis; undisrupted hlb with skin and soft tissue infections; and finally, CC5, msrA resistance gene and hla gene with osteoarticular source. Our study suggests an association between S. aureus genotype and place of acquisition, methicillin resistance and sources of bloodstream infection, and provides a valuable starting point for further research insights into intrinsic pathogenic mechanisms involved in the development of SAB. Frontiers Media https://hdl.handle.net/20.500.12105/22568
spellingShingle Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
Perez-Montarelo, Dame
Staphylococcus aureus bacteremia
Bacteremia source
Molecular epidemiology
Clonal complex
Virulence factors
title Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
title_full Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
title_fullStr Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
title_full_unstemmed Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
title_short Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
title_sort Molecular Epidemiology of Staphylococcus aureus Bacteremia: Association of Molecular Factors With the Source of Infection
topic Staphylococcus aureus bacteremia
Bacteremia source
Molecular epidemiology
Clonal complex
Virulence factors
topic_facet Staphylococcus aureus bacteremia
Bacteremia source
Molecular epidemiology
Clonal complex
Virulence factors
url https://hdl.handle.net/20.500.12105/22568