The increased frequency of methicillin-resistant Staphylococcus aureus with low MIC of beta-lactam antibiotics isolated from hospitalized patients

J Infect Chemother. 2020 Jun;26(6):604-610. doi: 10.1016/j.jiac.2020.01.016. Epub 2020 Feb 22.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) causes severe infectious diseases and can be life-threatening in healthcare-settings. MRSA is classified into health-care associated (HA)-MRSA strains and community acquired (CA)-MRSA strains based on genotype and phenotype. CA-MRSA has been reported to show the lower minimal inhibitory concentration (MIC) of some antibiotics as compared to HA-MRSA. Recently, the prevalence of CA-MRSA has been increased in worldwide. CA-MRSA is isolated not only from the healthy individuals in a community but also from the patients in healthcare settings. However, the changing trend in frequency of HA-MRSA and CA-MRSA in the hospital setting is not clear. Therefore, we analyzed the trend of MIC to speculate the frequency of HA-MRSA and CA-MRSA in the facility. Moreover, gene mutations were evaluated on resistant gene loci with next generation sequencer. The frequency of strains with low MIC of beta-lactam antibiotics was gradually increased in isolated MRSA strains from the hospitalized patients. Whole genome analysis revealed the frequency of gene mutation was also decreased in some resistant loci, such as blaZ and blaR1. These findings highlight the changing trend of MRSA strains isolated from hospitalized patients.

Keywords: CA-MRSA; MRSA; Whole genome sequencing.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / microbiology
  • Cross Infection / diagnosis
  • Cross Infection / microbiology
  • DNA, Bacterial
  • Drug Resistance, Multiple, Bacterial / genetics*
  • Female
  • Genotype
  • Humans
  • Japan
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Microbial Sensitivity Tests / trends
  • Middle Aged
  • Mutation
  • Prevalence
  • Protein Structure, Tertiary / genetics
  • Staphylococcal Infections / diagnosis
  • Whole Genome Sequencing
  • beta-Lactamases / genetics*
  • beta-Lactams / pharmacology*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • DNA, Bacterial
  • beta-Lactams
  • beta-Lactamases