Pimentel de Araujo Fernanda, Pirolo Mattia, Monaco Monica, Del Grosso Maria, Ambretti Simone, Lombardo Donatella, Cassetti Tiziana, Gargiulo Raffaele, Riccobono Eleonora, Visca Paolo, Pantosti Annalisa
Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
Department of Science, Roma Tre University, Rome, Italy.
Front Microbiol. 2022 Mar 3;13:846167. doi: 10.3389/fmicb.2022.846167. eCollection 2022.
is the most common pathogen causing osteomyelitis (OM). The aim of this study was to explore the clonal complex (CC) distribution and the pattern of virulence determinants of isolates from OM in Italy. Whole-genome sequencing was performed on 83 isolates from OM cases in six hospitals. Antibiotic susceptibility tests showed that 30.1% of the isolates were methicillin-resistant (MRSA). The most frequent CCs detected were CC22, CC5, CC8, CC30, and CC15, which represent the most common lineages circulating in Italian hospitals. MRSA were limited in the number of lineages (CC22, CC5, CC8, and CC1). Phylogenetic analysis followed the sequence type-CC groupings and revealed a non-uniform distribution of the isolates from the different hospitals. No significant difference in the mean number of virulence genes carried by MRSA or MSSA isolates was observed. Some virulence genes, namely , , , , , , , and , were correlated with the CC. However, different categories of virulence factors, such as adhesins, exoenzymes, and toxins, were frequently detected and unevenly distributed among all lineages. Indeed, each lineage carried a variable combination of virulence genes, likely reflecting functional redundancy, and arguing for the importance of those traits for the pathogenicity in OM. In conclusion, no specific genetic trait in the most frequent lineages could explain their high prevalence among OM isolates. Our findings highlight that CCs detected in OM isolates follow the epidemiology of infections in the country. It is conceivable that any of the most common CC can cause a variety of infections, including OM.
是引起骨髓炎（OM）最常见的病原体。本研究旨在探讨意大利OM分离株的克隆复合体（CC）分布及毒力决定因素模式。对来自六家医院OM病例的83株分离株进行了全基因组测序。药敏试验表明，30.1%的分离株对甲氧西林耐药（MRSA）。检测到的最常见CC为CC22、CC5、CC8、CC30和CC15，它们代表了意大利医院中最常见的流行谱系。MRSA的谱系数量有限（CC22、CC5、CC8和CC1）。系统发育分析遵循序列类型-CC分组，结果显示不同医院的分离株分布不均匀。未观察到MRSA或MSSA分离株携带的毒力基因平均数量有显著差异。一些毒力基因，即 、 、 、 、 、 、 和 ，与CC相关。然而，不同类别的毒力因子，如黏附素、外酶和毒素，在所有谱系中都经常被检测到且分布不均。实际上，每个谱系携带毒力基因的可变组合，这可能反映了功能冗余，并表明这些特征对OM致病性的重要性。总之，最常见谱系中没有特定的遗传特征可以解释它们在OM分离株中的高流行率。我们的研究结果强调，OM分离株中检测到的CC遵循该国感染的流行病学情况。可以想象，任何一种最常见的CC都可能引起包括OM在内的多种感染。
