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Emergence and spread of worldwide Staphylococcus aureus clones among cystic fibrosis patients

Authors Garbacz K, Piechowicz L, Podkowik M, Mroczkowska A, Empel J, Bania J

Received 6 October 2017

Accepted for publication 7 December 2017

Published 22 February 2018 Volume 2018:11 Pages 247—255

DOI https://doi.org/10.2147/IDR.S153427

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Eric Nulens


Katarzyna Garbacz,1 Lidia Piechowicz,2 Magdalena Podkowik,3 Aneta Mroczkowska,4 Joanna Empel,4 Jacek Bania3

1Department of Oral Microbiology, Medical University of Gdansk, Gdansk, Poland; 2Department of Medical Microbiology, Medical University of Gdansk, Gdansk, Poland; 3Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland; 4Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland

Background: The aim of this study was to assess the relatedness of molecular types of Staphylococcus aureus isolates colonizing cystic fibrosis (CF) patients with their antimicrobial resistance and prevalence of toxin genes.
Methods: A total of 215 isolates from the airways of 107 patients with CF were tested for spa and SCCmec type, antimicrobial resistance and carriage of toxin genes.
Results: t015, t084, t091, t700 and t002 were the largest group (approximately 25%) among all 69 identified spa types. Five new spa types, t14286, t14287, t14288, t14289 and t14290, were identified and registered. Isolates from CF patients were clustered into 11 multi-locus sequence typing clonal complexes, with CC30, CC22, CC97, CC45, CC15 and CC5 being the most frequent ones. Twelve (5.6%) methicillin-resistant S. aureus (MRSA) isolates and 102 (47.7%) multidrug-resistant isolates were identified, along with three SCCmec types (I, III and V). All isolates (both MRSA and methicillin-sensitive S. aureus) were Panton–Valentine leucocidin-negative, and 56.7% harbored egc genes. This was the first study documenting the presence of ST398-V-t571 livestock-associated MRSA in a European patient with CF.
Conclusion: These findings imply that individuals with CF can also be colonized with animal-related ST398 MRSA, and justify constant monitoring of staphylococcal colonization and identification of epidemic S. aureus clones in this group.

Keywords:
Staphylococcus aureus, cystic fibrosis, ST398 MRSA, Panton–Valentine leukocidin, spa typing, MRSA

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