A prospective cohort multicenter study of molecular epidemiology and phylogenomics of Staphylococcus aureus bacteremia in nine Latin American countries

Cesar A. Arias, Jinnethe Reyes, Lina Paola Carvajal, Sandra Rincon, Lorena Diaz, Diana Panesso, Gabriel Ibarra, Rafael Rios, Jose M. Munita, Mauro J. Salles, Carlos Alvarez-Moreno, Jaime Labarca, Coralith Garcia, Carlos M. Luna, Carlos Mejia-Villatoro, Jeannete Zurita, Manuel Guzman-Blanco, Eduardo Rodriguez-Noriega, Apurva Narechania, Laura J. Rojas & 4 others Paul J. Planet, George M. Weinstock, Eduardo Gotuzzo, Carlos Seas

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Staphylococcus aureus is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant S. aureus (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 S. aureus) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette mec [SCCmec] I and II). Clade B included ST8, ST88, ST97, and ST72 strains (SCCmec IV, subtypes a, b, and c/E), and clade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA.

Original languageEnglish (US)
Article numbere00816
JournalAntimicrobial Agents and Chemotherapy
Volume61
Issue number10
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

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Molecular Epidemiology
Methicillin-Resistant Staphylococcus aureus
Bacteremia
Multicenter Studies
Staphylococcus aureus
Cohort Studies
Ecuador
Colombia
Latin America
Soft Tissue Infections
Pulsed Field Gel Electrophoresis
Infection
Genome
Anti-Bacterial Agents
Skin

Keywords

  • Bacteremia
  • Latin America
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

A prospective cohort multicenter study of molecular epidemiology and phylogenomics of Staphylococcus aureus bacteremia in nine Latin American countries. / Arias, Cesar A.; Reyes, Jinnethe; Carvajal, Lina Paola; Rincon, Sandra; Diaz, Lorena; Panesso, Diana; Ibarra, Gabriel; Rios, Rafael; Munita, Jose M.; Salles, Mauro J.; Alvarez-Moreno, Carlos; Labarca, Jaime; Garcia, Coralith; Luna, Carlos M.; Mejia-Villatoro, Carlos; Zurita, Jeannete; Guzman-Blanco, Manuel; Rodriguez-Noriega, Eduardo; Narechania, Apurva; Rojas, Laura J.; Planet, Paul J.; Weinstock, George M.; Gotuzzo, Eduardo; Seas, Carlos.

In: Antimicrobial Agents and Chemotherapy, Vol. 61, No. 10, e00816, 01.10.2017.

Research output: Contribution to journalArticle

Arias, CA, Reyes, J, Carvajal, LP, Rincon, S, Diaz, L, Panesso, D, Ibarra, G, Rios, R, Munita, JM, Salles, MJ, Alvarez-Moreno, C, Labarca, J, Garcia, C, Luna, CM, Mejia-Villatoro, C, Zurita, J, Guzman-Blanco, M, Rodriguez-Noriega, E, Narechania, A, Rojas, LJ, Planet, PJ, Weinstock, GM, Gotuzzo, E & Seas, C 2017, 'A prospective cohort multicenter study of molecular epidemiology and phylogenomics of Staphylococcus aureus bacteremia in nine Latin American countries', Antimicrobial Agents and Chemotherapy, vol. 61, no. 10, e00816. https://doi.org/10.1128/AAC.00816-17
Arias, Cesar A. ; Reyes, Jinnethe ; Carvajal, Lina Paola ; Rincon, Sandra ; Diaz, Lorena ; Panesso, Diana ; Ibarra, Gabriel ; Rios, Rafael ; Munita, Jose M. ; Salles, Mauro J. ; Alvarez-Moreno, Carlos ; Labarca, Jaime ; Garcia, Coralith ; Luna, Carlos M. ; Mejia-Villatoro, Carlos ; Zurita, Jeannete ; Guzman-Blanco, Manuel ; Rodriguez-Noriega, Eduardo ; Narechania, Apurva ; Rojas, Laura J. ; Planet, Paul J. ; Weinstock, George M. ; Gotuzzo, Eduardo ; Seas, Carlos. / A prospective cohort multicenter study of molecular epidemiology and phylogenomics of Staphylococcus aureus bacteremia in nine Latin American countries. In: Antimicrobial Agents and Chemotherapy. 2017 ; Vol. 61, No. 10.
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AU - Rincon, Sandra

AU - Diaz, Lorena

AU - Panesso, Diana

AU - Ibarra, Gabriel

AU - Rios, Rafael

AU - Munita, Jose M.

AU - Salles, Mauro J.

AU - Alvarez-Moreno, Carlos

AU - Labarca, Jaime

AU - Garcia, Coralith

AU - Luna, Carlos M.

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AU - Guzman-Blanco, Manuel

AU - Rodriguez-Noriega, Eduardo

AU - Narechania, Apurva

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AU - Seas, Carlos

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N2 - Staphylococcus aureus is an important pathogen causing a spectrum of diseases ranging from mild skin and soft tissue infections to life-threatening conditions. Bloodstream infections are particularly important, and the treatment approach is complicated by the presence of methicillin-resistant S. aureus (MRSA) isolates. The emergence of new genetic lineages of MRSA has occurred in Latin America (LA) with the rise and dissemination of the community-associated USA300 Latin American variant (USA300-LV). Here, we prospectively characterized bloodstream MRSA recovered from selected hospitals in 9 Latin American countries. All isolates were typed by pulsed-field gel electrophoresis (PFGE) and subjected to antibiotic susceptibility testing. Whole-genome sequencing was performed on 96 MRSA representatives. MRSA represented 45% of all (1,185 S. aureus) isolates. The majority of MRSA isolates belonged to clonal cluster (CC) 5. In Colombia and Ecuador, most isolates (72%) belonged to the USA300-LV lineage (CC8). Phylogenetic reconstructions indicated that MRSA isolates from participating hospitals belonged to three major clades. Clade A grouped isolates with sequence type 5 (ST5), ST105, and ST1011 (mostly staphylococcal chromosomal cassette mec [SCCmec] I and II). Clade B included ST8, ST88, ST97, and ST72 strains (SCCmec IV, subtypes a, b, and c/E), and clade C grouped mostly Argentinian MRSA belonging to ST30. In summary, CC5 MRSA was prevalent in bloodstream infections in LA with the exception of Colombia and Ecuador, where USA300-LV is now the dominant lineage. Clonal replacement appears to be a common phenomenon, and continuous surveillance is crucial to identify changes in the molecular epidemiology of MRSA.

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