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Genetic characterization of Panton–Valentine leukocidin-producing methicillin-resistant Staphylococcus aureus in Western Austria

Genetische Charakterisierung von Panton-Valentine Leukozidin produzierenden Methicillin-resistenten Staphylococcus aureus in Westösterreich

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Abstract

Background

Community-acquired methicillin-resistant Staphylococcus aureus (caMRSA) is an emerging pathogen which causes potentially severe infections in young and healthy individuals due to the ability of most strains to produce Panton–Valentine leukocidin (PVL).

The aim of this study was to evaluate the prevalence of PVL-positive (PVL+)-MRSA strains in Western Austria in the period from December 2005 to May 2010 and to characterize the identified PVL+-MRSA strains.

Methods

Six hundred and fifty MRSA strains from Innsbruck Medical University hospital, district hospitals, and general practitioners were investigated for the presence of lukS–lukF gene (encoding for PVL). Antimicrobial resistance testing, SCCmec-, agr-, MLST- and spa-typing, as well as arcA determination were performed on PVL+-MRSA.

Results

Among 650 MRSA strains collected from various body sites from hospitalized patients and outpatients, 31 strains (4.8 %) were positive for lukS-lukF and thus identified as PVL+-MRSA.

Agr-1 was the most common agr-type (n = 18, 58.1 %) and SCCmec-IV or variants IVa and IVc were the most common SCCmec types (n = 27, 87.1 %). All tested strains showed in-vitro susceptibility to vancomycin and rifampicin, but resistance against cotrimoxazol (6.4 %), clindamycin (9.7 %), gentamicin (9.7 %), fusidic acid (12.9 %), levofloxacin (12.9 %), and erythromycin (61.3 %) was found.

Most lukS-lukF-positive MRSA detected in our survey shared ST8 and t008 and were positive for arcA.

Conclusions

The major lukS-lukF-positive MRSA lineage found in our population was ST8, t008 and positive for arcA which is mainly found in the USA. In contrast, ST80 strains were not found as frequently in our region as in many other European countries.

Zusammenfassung

Grundlagen

Community-acquired methicillin-resistente Staphylococcus aureus (caMRSA) stellen ein zunehmendes gesundheitsökonomisches Problem dar. Sie können speziell bei ansonsten gesunden Patienten schwerwiegende Infektionen auslösen, was vermutlich auf die Fähigkeit einiger Stämme, Panton-Valentine Leukozidin (PVL) zu produzieren, zurückzuführen ist. Das Ziel dieser Studie war es, die Prävalenz von PVL-positiven (PVL+)-MRSA in Westösterreich im Zeitraum von Dezember 2005 bis Mai 2010 zu erheben und identifizierte PVL+-MRSA genetisch zu charakterisieren.

Methodik

Sechshundertfünfzig MRSA-Stämme der Medizinischen Universität Innsbruck, von Bezirkskrankenhäusern und von niedergelassenen Ärzten in Westösterreich wurden auf das Vorhandensein des lukS-lukF Gens (welches für PVL kodiert) untersucht. Identifizierte PVL+-MRSA wurden auf Antibiotika-Resistenz getestet. Weiteres wurden der SCCmec-, agr-, MLST- und spa-Typ bestimmt sowie auf das Vorhandensein des arcA-Gens untersucht.

Ergebnisse

Von 650 MRSA, welche von verschiedenen Körperregionen sowohl von hospitalisierten wie auch von nicht-hospitalisierten Patienten isoliert wurden, wurden 31 (4,8 %) als PVL+-MRSA identifiziert. Der in unserer Untersuchung am häufigsten vorkommende agr-Typ war agr-1 (n = 18, 58,1 %), die häufigsten SCCmec-Typen waren SCCmec IV oder die Varianten IVa und IVc (n = 27, 87,1 %). Alle untersuchten Stämme waren empfindlich auf Vancomycin und Rifampicin. Es zeigten sich jedoch Resistenzen gegen Co-trimoxazol (6,4 %), Clindamycin (9,7 %), Gentamicin (9,7 %), Fusidinsäure (12,9 %), Levofloxacin (12,9 %) und Erythromycin (61,3 %). Die meisten lukS-lukF-positiven MRSA in unserer Studie zeigten ST8, t008 und waren positiv auf arcA.

Schlussfolgerungen

Der Hauptteil der in unserer Untersuchung identifizierten lukS-lukF-positiven MRSA-Stämme zeigte ST8, t008 und war arcA-positiv. Ein Phänotyp, welcher hauptsächlich aus den USA beschrieben ist. ST80-Stämme wurden in unserer Untersuchung nicht so häufig wie in anderen europäischen Ländern identifiziert.

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The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz-Pregl-Straße 3, 6020, Innsbruck, Austria

    Michael Berktold, Katharina Grif, Martin Mäser, Reinhard Würzner & Dorothea Orth-Höller

  2. Division of Pediatrics, Regional Hospital Feldkirch, Feldkirch, Austria

    Martin Mäser

  3. Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany

    Wolfgang Witte

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  1. Michael Berktold
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  2. Katharina Grif
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  3. Martin Mäser
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  4. Wolfgang Witte
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Correspondence to Reinhard Würzner.

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Berktold, M., Grif, K., Mäser, M. et al. Genetic characterization of Panton–Valentine leukocidin-producing methicillin-resistant Staphylococcus aureus in Western Austria. Wien Klin Wochenschr 124, 709–715 (2012). https://doi.org/10.1007/s00508-012-0244-8

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