一项通过全基因组测序对 12 个国家在 17 年间从医院和社区环境中分离的新型 Panton-Valentine 白细胞毒素阳性、耐甲氧西林、CC5 型、IVc 克隆金黄色葡萄球菌的研究。
An emerging Panton-Valentine leukocidin-positive CC5-meticillin-resistant Staphylococcus aureus-IVc clone recovered from hospital and community settings over a 17-year period from 12 countries investigated by whole-genome sequencing.
机构信息
Microbiology Research Unit, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin, Ireland.
Leibniz Institute of Photonic Technology (IPHT), Jena, Germany; Institut für Medizinische Mikrobiologie und Virologie, Uniklinikum Dresden, Dresden, Germany; InfectoGnostics Research Campus, Jena, Germany.
出版信息
J Hosp Infect. 2023 Feb;132:8-19. doi: 10.1016/j.jhin.2022.11.015. Epub 2022 Dec 5.
BACKGROUND
A novel Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) clonal complex (CC)5-MRSA-IVc ('Sri Lankan' clone) was recently described from Sri Lanka. Similar isolates caused a recent Irish hospital outbreak.
AIM
To investigate the international dissemination and diversity of PVL-positive CC5-MRSA-IVc isolates from hospital and community settings using whole-genome sequencing (WGS).
METHODS
Core-genome single nucleotide polymorphism (cgSNP) analysis, core-genome multi-locus sequence typing (cgMLST) and microarray-based detection of antimicrobial-resistance and virulence genes were used to investigate PVL-positive CC5-MRSA-IVc (N = 214 including 46 'Sri Lankan' clone) from hospital and community settings in 12 countries over 17 years. Comparators included 29 PVL-positive and 23 PVL-negative CC5/ST5-MRSA-I/II/IVa/IVc/IVg/V.
RESULTS
Maximum-likelihood cgSNP analysis grouped 209/214 (97.7%) CC5-MRSA-IVc into Clade I; average of 110 cgSNPs between isolates. Clade III contained the five remaining CC5-MRSA-IVc; average of 92 cgSNPs between isolates. Clade II contained seven PVL-positive CC5-MRSA-IVa comparators, whereas the remaining 45 comparators formed an outlier group. Minimum-spanning cgMLST analysis revealed a comparably low average of 57 allelic differences between all CC5/ST5-MRSA-IVc. All 214 CC5/ST5-MRSA-IVc were identified as 'Sri Lankan' clone, predominantly spa type t002 (186/214) with low population diversity and harboured a similar range of virulence genes and variable antimicrobial-resistance genes. All 214 Sri Lankan clone isolates and Clade II comparators harboured a 9616-bp chromosomal PVL-encoding phage remnant, suggesting both arose from a PVL-positive meticillin-susceptible ancestor. Over half of Sri Lankan clone isolates were from infections (142/214), and where detailed metadata were available (168/214), most were community associated (85/168).
CONCLUSIONS
Stable chromosomal retention of pvl may facilitate Sri-Lankan clone dissemination.
背景
最近在斯里兰卡发现了一种新型的杀白细胞素阳性（PVL）耐甲氧西林金黄色葡萄球菌（MRSA）克隆复合体（CC）5-MRSA-IVc（“斯里兰卡”克隆）。类似的分离株引起了最近爱尔兰医院的一次暴发。
目的
使用全基因组测序（WGS）研究来自医院和社区环境的杀白细胞素阳性 CC5-MRSA-IVc 分离株的国际传播和多样性。
方法
核心基因组单核苷酸多态性（cgSNP）分析、核心基因组多位点序列分型（cgMLST）和基于微阵列的抗菌药物耐药性和毒力基因检测用于研究来自 12 个国家的 17 年间医院和社区环境中的 214 株杀白细胞素阳性 CC5-MRSA-IVc（包括 46 株“斯里兰卡”克隆）。对照包括 29 株杀白细胞素阳性和 23 株杀白细胞素阴性 CC5/ST5-MRSA-I/II/IVa/IVc/IVg/V。
结果
最大似然 cgSNP 分析将 214 株 CC5-MRSA-IVc 中的 209 株（97.7%）分为 Clade I；株间平均有 110 个 cgSNP。Clade III 包含其余 5 株 CC5-MRSA-IVc；株间平均有 92 个 cgSNP。Clade II 包含 7 株杀白细胞素阳性 CC5-MRSA-IVa 对照株，而其余 45 株对照株形成一个异常组。最小跨度 cgMLST 分析显示，所有 CC5/ST5-MRSA-IVc 株间的平均等位基因差异较小，为 57 个。所有 214 株 CC5/ST5-MRSA-IVc 均被鉴定为“斯里兰卡”克隆，主要 spa 型 t002（186/214），种群多样性低，携带类似范围的毒力基因和可变的抗菌药物耐药基因。所有 214 株斯里兰卡克隆分离株和 Clade II 对照株均携带一个 9616 碱基对的染色体 PVL 编码噬菌体残余物，表明两者均起源于一个杀白细胞素阳性的耐甲氧西林敏感的祖先。超过一半的斯里兰卡克隆分离株来自感染（142/214），在提供详细元数据的情况下（168/214），大多数来自社区（85/168）。
结论
pvl 的稳定染色体保留可能有助于斯里兰卡克隆的传播。
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