Increase in the prevalence of Panton-Valentine leukocidin and clonal shift in community-onset methicillin-resistant Staphylococcus aureus causing skin and soft-tissue infections in the Rhine-Neckar Region, Germany, 2012-2016

• Verfasst von: Klein, Sabrina [VerfasserIn]
• Verfasst von: Menz, Monja-Dorina [VerfasserIn]
• Verfasst von: Zanger, Philipp [VerfasserIn]
• Verfasst von: Heeg, Klaus [VerfasserIn]
• Verfasst von: Nurjadi, Dennis [VerfasserIn]
• Titel: Increase in the prevalence of Panton-Valentine leukocidin and clonal shift in community-onset methicillin-resistant Staphylococcus aureus causing skin and soft-tissue infections in the Rhine-Neckar Region, Germany, 2012-2016
• Verf.angabe: Sabrina Klein, Monja-Dorina Menz, Philipp Zanger, Klaus Heeg, Dennis Nurjadi
• Jahr: 2019
• Jahr des Originals: 2018
• Umfang: 7 S.
• Fussnoten: Available online 6 November 2018 ; Gesehen am 03.04.2019
• Titel Quelle: Enthalten in: International journal of antimicrobial agents
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1991
• Jahr Quelle: 2019
• Band/Heft Quelle: 53(2019), 3, Seite 261-267
• ISSN Quelle: 1872-7913
• DOI: doi:10.1016/j.ijantimicag.2018.10.026
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Antimicrobial resistance
• Sach-SW: Community-onset MRSA
• Sach-SW: Import
• Sach-SW: Panton-Valentine leukocidin
• Sach-SW: Skin and soft-tissue infection
• K10plus-PPN: 1662788460

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) remains a major challenge for patient care. Community-associated (CA)-MRSA often have a fitness and virulence advantage compared with their nosocomial counterparts. Increased mobility, travel activities and migration accelerate the intercontinental spread of virulent CA-MRSA strains. Outpatient clinics are the most important route of entry for CA-MRSA into hospitals. However, systematic data on CA-MRSA in Germany are limited. In this study, community-onset (CO)-MRSA skin and soft-tissue infection (SSTI) isolates in the Rhine-Neckar Region from 2012-2016 were characterised to gain an insight into their molecular epidemiology and to monitor potential introduction of virulent and dominant MRSA strains into our hospital. A total of 2475 patients with S. aureus SSTI were identified in the outpatient departments of our hospital, of which 94 (3.8%) were MRSA. In addition, 40.4% of the CO-MRSA harboured the virulence factor Panton-Valentine leukocidin (PVL). ST8-t008-MRSA-IVa/c (23.7%; 9/39) and ST80-t044-MRSA-IVc (15.8%; 6/38) were the predominant PVL-positive MRSA. Molecular typing and epidemiological data revealed that 42.6% (40/94) of strains could be traced back to a local origin and 44.7% (42/94) were endemic outside of Europe. Resistance to quinolones, clindamycin and macrolides was common, whilst resistance to trimethoprim/sulfamethoxazole, tetracycline, mupirocin, chlorhexidine and fusidic acid was low. No resistance to rifampicin, fosfomycin or linezolid was observed. This study provides insight into the clonal composition of CO-MRSA in the Rhine-Neckar Region. The increase of PVL-positive MRSA and the introduction of imported strains may affect the local MRSA landscape in the near future and should be monitored closely.