The molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in the Czech Republic

Author:

Tkadlec Jan1,Capek Vaclav2,Brajerova Marie1,Smelikova Eva1,Melter Oto1,Bergerova Tamara3,Polivkova Sylvia4,Balejova Magda5,Hanslianova Marketa6,Fackova Daniela7,Neradova Katerina8,Tejkalova Renata9,Vagnerova Iva10,Bartonikova Natasa11,Chmelarova Eva12,Drevinek Pavel1,Krutova Marcela1

Affiliation:

1. Department of Medical Microbiology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic

2. Bioinformatics Centre, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic

3. Department of Microbiology, Faculty of Medicine and University Hospital Plzen, Charles University in Prague, Plzen, Czech Republic

4. Department of Infectious Diseases, Charles University, 3rd Faculty of Medicine and Bulovka Teaching Hospital, Prague, Czech Republic

5. Department of Medical Microbiology, Hospital Ceske Budejovice, Czech Republic

6. Department of Medical Microbiology, University Hospital Brno, Czech Republic

7. Department of Medical Microbiology and Immunology, Hospital Liberec, Czech Republic

8. Department of Clinical Microbiology, University Hospital Hradec Kralove, Czech Republic

9. Department of Medical Microbiology, Faculty of Medicine, Masaryk University and St Anne’s University Hospital, Brno, Czech Republic

10. Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Czech Republic

11. Department of Medical Microbiology, Tomas Bata’s Hospital Zlin, Czech Republic

12. Department of Microbiology, Agel Laboratories a.s., Ostrava-Vitkovice, Czech Republic

Abstract

Abstract Objectives To gain data on the current molecular epidemiology and resistance of MRSA in the Czech Republic. Methods Between September 2017 and January 2018, a total of 441 single-patient MRSA isolates were collected from 11 Czech hospitals and analysed by spa typing, SCCmec typing, antibiotic susceptibility testing, detection of the PVL toxin and the arcA gene. Results Of all MRSA isolates, 81.41% (n = 359) belonged to the CC5-MRSA clone represented by the spa types t003 (n = 136), t586 (n = 92), t014 (n = 81), t002 (n = 20) and other spa types (n = 30); a majority of the CC5 isolates (n = 348, 96.94%) carried SCCmec type II. The occurrence of CC5-MRSA was more likely in older inpatients and associated with a healthcare origin (P < 0.001). The CC5-MRSA isolates were resistant to more antimicrobial drugs compared with the other MRSAs (P < 0.001). Interestingly, t586 was detected in blood samples more often than the other spa types and, contrary to other spa types belonging to CC5-MRSA, t586 was not associated with patients of advanced age. Other frequently found lineages were CC8 (n = 17), CC398 (n = 11) and CC59 (n = 10). The presence of the PVL was detected in 8.62% (n = 38) of the MRSA isolates. Conclusions The healthcare-associated CC5-MRSA-II lineage (t003, t586, t014) was found to be predominant in the Czech Republic. t586 is a newly emerging spa type in the Czech Republic, yet reported rarely in other countries. Our observations stress the need for MRSA surveillance in the Czech Republic in order to monitor changes in MRSA epidemiology.

Funder

Ministry of Health of the Czech Republic

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)

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