Bengal Bay clone ST772-MRSA-V outbreak - conserved clone causes investigation challenges

Summary Background The Bengal Bay clone, ST772-MRSA-V, associated with multidrug resistance, Panton-Valentine leukocidin (PVL) and skin and soft tissue infections, is emerging worldwide. In Norway, a country with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA), increased occurren...

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Published in:The Journal of hospital infection 2017-03, Vol.95 (3), p.253-258
Main Authors: Blomfeldt, Anita, Larssen, Kjersti Wik, Moghen, Arsalan, Haugum, Kjersti, Steen, Tore W, Jørgensen, Silje Bakken, Aamot, Hege Vangstein
Format: Article
Language:English
Subjects:
Clone Cells
Cross Infection - epidemiology
Cross Infection - microbiology
Disease Outbreaks
Genotype
Humans
Infectious Disease
Methicillin-Resistant Staphylococcus aureus - classification
Methicillin-Resistant Staphylococcus aureus - genetics
Methicillin-Resistant Staphylococcus aureus - isolation & purification
MLVF/MLVA
Molecular Epidemiology - methods
Molecular Typing - methods
Norway - epidemiology
Outbreak
PFGE
spa typing
ST772-MRSA-V
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcus aureus
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Summary:Summary Background The Bengal Bay clone, ST772-MRSA-V, associated with multidrug resistance, Panton-Valentine leukocidin (PVL) and skin and soft tissue infections, is emerging worldwide. In Norway, a country with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA), increased occurrence of ST772-MRSA-V HAS also caused hospital outbreaks. The conserved nature of this clone challenged the outbreak investigations. Aim The aim of the present study was to evaluate the usefulness of spa typing, multiple-locus variable number tandem repeat fingerprinting/analysis (MLVF/MLVA) and pulsed-field gel electrophoresis (PFGE) when investigating outbreaks with a conserved MRSA clone. Methods A panel of 25 MRSA isolates collected in 2004-2014 consisting of six hospital outbreak isolates and 19 sporadic isolates were analyzed using spa typing, PCR detection of genes encoding PVL, MLVF/MLVA and PFGE. Findings All isolates were ST772-MRSA-V-t657, resistant to erythromycin, gentamicin, and norfloxacin, and 88% were PVL positive. PFGE could not discriminate between the isolates (≥85% similarity). MLVF resolved five types (Simpson’s index of diversity [SID] = 0.56), MLVA six types (SID = 0.66), and both methods separated the hospital isolates into two defined outbreaks. Conclusion MLVF/MLVA could not discriminate all epidemiologically unlinked cases and identical genotypes originated from a timespan of ten years. MLVA was regarded most suitable due to its higher discriminatory power and ability to provide unambiguous profiles. The Bengal Bay clone may, however, require higher resolution methods for exact demarcation of outbreaks due to low diversity among isolates.
ISSN:0195-6701
1532-2939
DOI:10.1016/j.jhin.2016.12.006