The aim of this study was to trace the dynamic changes of methicillin-resistant Staphylococcus aureus (MRSA) lineages in the local hospital in both the national and international context. We describe genotypic and phenotypic characterization of 62 non-duplicate MRSA isolates collected during 2010-2016 at University Hospital in Hradec Kralove, Czech Republic. The isolates were characterized by multilocus sequence typing (MLST), spa typing, and staphylococcal cassette chromosome mec typing (SCCmec typing). Eight different genotypes were described; ST225-t003-II (32/62, 52%), ST5-t002-II (13/62, 22%), and ST225-t014-II (12/62, 21%) were constantly detected over the 7-year follow-up period. The genotypes ST225-t151-II, ST225-t1282-II, ST225-t1623-II, ST78-t2832-II, and ST225-t8799-II occurred only once in the period reported. The majority of the strains, represented by ST225, belonged to clonal complex 5 (CC5).

Department of Clinical Microbiology Faculty of Medicine and University Hospital Charles University Hradec Kralove Czech Republic

Department of Medical Microbiology Charles University 3rd Faculty of Medicine Prague Czech Republic

Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

National Reference Laboratory for Antibiotics National Institute of Public Health Prague Czech Republic

Zobrazit více v PubMed

European Centre for Disease Prevention and Control Antimicrobial resistance surveillance in Europe (2016) Annual Report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) 2016. https://www.ecdc.europa.eu/en/publications-data/antimicrobial-resistancesurveillance-europe-2016. Accessed 24 July 2019

Baig S, Johannesen TB, Overballe-Petersen S, Larsen J, Larsen AR, et al. Novel SCCmec type XIII (9a) identified in an ST152 methicillin-resistant Staphylococcus aureus. Infect Genet Evol. 2018;61:74–76. doi: 10.1016/j.meegid.2018.03.013. PubMed DOI

Challagundla L, Reyes J, Rafiqullah I, et al. Phylogenomic classification and the evolution of clonal complex 5 methicillin-resistant Staphylococcus aureus in the Western Hemisphere. Front Microbiol. 2018;5:1901. doi: 10.3389/fmicb.2018.01901. PubMed DOI PMC

Coello R, Glynn JR, Gaspar C. Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA. J Hosp Infect. 1997;37:39–46. doi: 10.1016/s0195-6701(97)90071-2. PubMed DOI

Cuny C, Layer F, Werner GATAL. State-wide surveillance of antibiotic resistance patterns and spa types of methicillin-resistant Staphylococcus aureus from blood cultures in North Rhine-Westphalia, 2011-2013. Clin Microbiol Infect. 2015;21(8):750–757. doi: 10.1016/j.cmi.2015.02.013. PubMed DOI

de Kraker MEA, Wolkewitz M, Davey PG, Grundmann H. Clinical impact of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay related to methicillin-resistant Staphylococcus aureus bloodstream infections. Antimicrob Agents Chemother. 2011;55:1598–1605. doi: 10.1128/AAC.01157-10. PubMed DOI PMC

Enright MC, Day NPJ, Davies CE, Peacock SJ, Spratt BG. Multilocus sequence typing for characterization of methicillin-resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol. 2000;38:1008–1015. doi: 10.1128/JCM.38.3.1008-1015.2000. PubMed DOI PMC

Ficca G, Chauvel M, de Moüy D, Membres du Réseau des Biologistes de Ville de l’AFORCOPI-BIO Prevalence of community-acquired methicillin-résistant Staphylococcus aureus. Med Mal Infect. 2006;36(4):207–212. doi: 10.1016/j.medmal.2005.11.016. PubMed DOI

Gamblin J, Jefferies JM, Harris S, et al. Nasal self-swabbing for estimating the prevalence of Staphylococcus aureus in the community. J Med Microbiol. 2013;62(3):437–440. doi: 10.1099/jmm.0.051854-0. PubMed DOI

Grundmann H, Aanensen DM, van den Wijngaard CC, et al. Geographic distribution of Staphylococcus aureus causing invasive infections in Europe: a molecular-epidemiological analysis. PLoS Med. 2010;7:e1000215. doi: 10.1371/journal.pmed.1000215. PubMed DOI PMC

Harmsen D, Claus H, Witte W, et al. Typing of methicillin-resistant Staphylococcus aureus in a University Hospital setting by using novel software for spa repeat determination and database management. J Clin Microbiol. 2003;41(12):5442–5448. doi: 10.1128/JCM.41.12.5442-5448.2003. PubMed DOI PMC

Institute of Health Information and Statistics of the Czech Republic (2018) Hospitalization in hospitals in the CR 2017. https://www.uzis.cz/category/tematicke-rady/zdravotnicka-statistika/hospitalizovani. Accessed 18 Nov 2019

Kasprzyk J, Piechowicz L, Wiśniewska K, et al. Differentiation of spa types and staphylococcal cassette chromosome mec (SCCmec) in clinical methicillin-resistant Staphylococcus aureus isolated in medical sites of Gdańsk region. Med Dosw Mikrobiol. 2015;67(2):79–88. PubMed

Köck R, Brakensiek L, Mellmann F, et al. Cross-border comparison of the admission prevalence and clonal structure of meticillin-resistant Staphylococcus aureus. J Hosp Infect. 2009;71(4):320–326. doi: 10.1016/j.jhin.2008.12.001. PubMed DOI

Köck R, Werner P, Friedrich AW, et al. Persistence of nasal colonization with human pathogenic bacteria and associated antimicrobial resistance in the German general population. New Microbes New Infect. 2016;37:24–34. doi: 10.1016/j.nmni.2015.11.004. PubMed DOI PMC

Laurent C, Bogaerts P, Schoevaerdts D, et al. Evaluation of the Xpert MRSA assay for rapid detection of methicillin-resistant Staphylococcus aureus from nares swabs of geriatric hospitalized patients and failure to detect a specific SCCmec type IV variant. Eur J Clin Microbiol Infect Dis. 2010;29:995. doi: 10.1007/s10096-010-0958-3. PubMed DOI

Mehraj Jaishri, Akmatov Manas K., Strömpl Julia, Gatzemeier Anja, Layer Franziska, Werner Guido, Pieper Dietmar H., Medina Eva, Witte Wolfgang, Pessler Frank, Krause Gérard. Methicillin-Sensitive and Methicillin-Resistant Staphylococcus aureus Nasal Carriage in a Random Sample of Non-Hospitalized Adult Population in Northern Germany. PLoS ONE. 2014;9(9):e107937. doi: 10.1371/journal.pone.0107937. PubMed DOI PMC

Melter O, Sanches IS, Schindler J, et al. Methicillin-resistant Staphylococcus aureus clonal types in the Czech Republic. J Clin Microbiol. 1999;37(9):2798–2803. doi: 10.1128/JCM.37.9.2798-2803.1999. PubMed DOI PMC

Melter O, Aires de Sousa M, Urbaskova P, et al. Update on the major clonal types of methicillin-resistant Staphylococcus aureus in the Czech Republic. J Clin Microbiol. 2003;41:4998–5005. doi: 10.1128/JCM.41.11.4998-5005.2003. PubMed DOI PMC

Melter O, Urbaskova P, Jakubu V, et al (2006) Emergence of EMRSA-15 clone in hospitals throughout the Czech Republic. Wkly Releases 1997–2007 11:3017. 10.2807/esw.11.31.03017-en PubMed

Milheirico C, Oliveira DC, de Lencastre H. Update to the multiplex PCR strategy for assignment of mec element types in Staphylococcus aureus. Antimicrob Agents Chemother. 2007;51:3374–3377. doi: 10.1128/AAC.00275-07. PubMed DOI PMC

Monecke S, Coombs G, Shore AC, et al. A field guide to pandemic, Epidemic and Sporadic Clones of methicillin-resistant Staphylococcus aureus. PLoS One. 2011;6(4):e17936. doi: 10.1371/journal.pone.0017936. PubMed DOI PMC

Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparison of community- and healthcare-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976–2984. doi: 10.1001/jama.290.22.2976. PubMed DOI

Palavecino EL. Clinical, epidemiologic, and laboratory aspects of methicillin-resistant Staphylococcus aureus Infections. In: Ji Y (ed) Methicillin-Resistant Staphylococcus aureus (MRSA) Protocols. Methods Mol Biol. 2020;2069:1–28. doi: 10.1007/978-1-4939-9849-4_1. PubMed DOI

Riedel S, Von Stein D, Richardson K. Development of a prediction rule for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus carriage in a Veterans Affairs Medical Center population. Infect Control Hosp Epidemiol. 2008;29:969–971. doi: 10.1086/590662. PubMed DOI

Sassmannshausen R, Deurenberg RH, Köck R, et al. MRSA prevalence and associated risk factors among health-care workers in non-outbreak situations in the Dutch-German EUREGIO. Front Microbiol. 2016;22(7):1273. doi: 10.3389/fmicb.2016.01273. PubMed DOI PMC

Stegger M, Andersen PS, Kearns A, et al. Rapid detection, differentiation and typing of methicillin-resistant Staphylococcus aureus harbouring either mecA or the new mecA homologue mecA (LGA251) Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2012;18:395–400. doi: 10.1111/j.1469-0691.2011.03715.x. PubMed DOI

Stock NK, Petras P, Melter O, et al. Importance of multifaceted approaches in infection control: a practical experience from an outbreak investigation. PLoS One. 2016;11(6):e0157981. doi: 10.1371/journal.pone.0157981. PubMed DOI PMC

Suetens C, Savey A, Lepape A et al (2015) European Centre for Disease Prevention and Control Technical Document, Surveillance of healthcare-associated infections and prevention indicators in European intensive care units, HAI-Net ICU protocol, version 2.2. https://www.ecdc.europa.eu/sites/portal/files/documents/HAI-Net-ICU-protocol-v2.2_0.pdf Accessed 19 November 2019

The European Committee on Antimicrobial Susceptibility Testing (2019) Breakpoint tables for interpretation of MICs and zone diameters, version 9.0. http://www.eucast.org/clinical_breakpoints/. Accessed 24 July 2019

Tkadlec J, Melter O, Cabrnochova M., Kekrt L, Drevinek P, Bergerova P, et al (2019) Methicillin-resistant Staphylococcus aureus spa-types t003, t586 and t014 - common cause of MRSA infection in Czech Republic. In e-library 29th European Congress of Clinical Microbiology & Infectious Diseases, Amsterodam 2019, L0062. https://www.escmid.org/escmid_publications/escmid_elibrary/?q=tkadlec+habalova&id=2173&L=0&x=0&y=0. Accessed 16 Apr 2019

University Hospital Hradec Kralove, Annual Report 2017 https://www.fnhk.cz/o-fakultni-nemocnici/vyrocni-zpravy. Accessed 15 Apr 2019

von Eiff C, Becker K, Machka K. Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med. 2001;344:11–16. doi: 10.1056/NEJM200101043440102. PubMed DOI

Zanelli G, Sansoni A, Zanchi A, et al. Staphylococcus aureus nasal carriage in the community: a survey from central Italy. Epidemiol Infect. 2002;129(2):417–420. doi: 10.1017/S0950268802007434. PubMed DOI PMC

Zarfel G, Luxner J, Folli B, et al. Increase of genetic diversity and clonal replacement of epidemic methicillin-resistant Staphylococcus aureus strains in South-East Austria. FEMS Microbiol Lett. 2016;363(14):fnw137. doi: 10.1093/femsle/fnw137. PubMed DOI PMC

Antibiotic Resistance, spa Typing and Clonal Analysis of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolates from Blood of Patients Hospitalized in the Czech Republic