Prevalence and molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus in the respiratory tracts of Chinese adults with community-acquired pneumonia

Yang Li; Yuanyue Tang; Zhuang Qiao; Zhongyi Jiang; Zhenyu Wang; Haiyan Xu; Xinan Jiao; Qiuchun Li

doi:10.1016/j.jiph.2023.03.014

Prevalence and molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus in the respiratory tracts of Chinese adults with community-acquired pneumonia

J Infect Public Health. 2023 May;16(5):713-718. doi: 10.1016/j.jiph.2023.03.014. Epub 2023 Mar 16.

Authors

Yang Li¹, Yuanyue Tang², Zhuang Qiao¹, Zhongyi Jiang¹, Zhenyu Wang¹, Haiyan Xu³, Xinan Jiao⁴, Qiuchun Li⁵

Affiliations

¹ Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China.
² Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China.
³ Nantong Center for Disease Control and Prevention, Nantong, China. Electronic address: slh1022@163.com.
⁴ Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China. Electronic address: jiao@yzu.edu.cn.
⁵ Jiangsu Key Lab of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, China; Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agri-food Safety and Quality, Ministry of Agriculture of China, Yangzhou University, China; Joint International Research Laboratory of Agriculture and Agri-Product Safety, Yangzhou University, China. Electronic address: qcli@yzu.edu.cn.

PMID: 36940498
DOI: 10.1016/j.jiph.2023.03.014

Abstract

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an important pathogen causing healthcare-associated infections. In recent years, an increasing number of CA-MRSA clones have emerged and rapidly spread in the community and hospital settings in China.

Objectives: To investigate the molecular epidemiology and resistance of CA-MRSA in the respiratory tracts of Chinese adults with community-acquired pneumonia (CAP).

Methods: A total of 243 sputum samples were collected from adult patients with CAP at the Nantong Hospital in China between 2018 and 2021. S. aureus was identified using PCR, and its susceptibility to 14 antimicrobials was tested using the broth dilution method. Genomic characterization of respiratory CA-MRSA and our previously collected intestinal CA-MRSA isolates was performed using whole-genome sequencing, and the evolutionary relationships of these isolates were assessed using phylogenetic analysis.

Results: The CA-MRSA colonization rate among adults with CAP in China was 7.8 % (19/243). Antimicrobial resistance analysis revealed that the proportion of multidrug-resistant respiratory CA-MRSA isolates (100 %) was higher than that of intestinal CA-MRSA isolates (6.3 %). Among the 35 CA-MRSA isolates, 10 MLST types were identified and clustered into five clone complexes (CCs). CC5 (48.6 %) and CC88 (20 %) were predominant CA-MRSA clones. Notably, the CC5 clone ST764/ST6292-MRSA-II-t002 was identified as the major lineage causing respiratory tract infections in Chinese adults with CAP.

Conclusions: The prevalence of CA-MRSA among Chinese adults with CAP is high and often involves ST764/ST6292-MRSA-II-t002 as the causal pathogen.

Keywords: Adult patients; Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA); Epidemiology; Intestinal tract; Respiratory tract.

MeSH terms

Adult
Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Community-Acquired Infections* / drug therapy
Community-Acquired Infections* / epidemiology
East Asian People
Humans
Methicillin-Resistant Staphylococcus aureus* / genetics
Microbial Sensitivity Tests
Multilocus Sequence Typing
Phylogeny
Pneumonia* / drug therapy
Prevalence
Respiratory System
Staphylococcal Infections* / drug therapy
Staphylococcal Infections* / epidemiology
Staphylococcus aureus

Substances

Anti-Bacterial Agents