Characteristics of Virulent ST5-SCC mec II Methicillin-Resistant Staphylococcus aureus Prevalent in a Surgery Ward

Lei Huang; Chengcheng Liu; Zhanjie Li; Xu Huang; Ruiying Zheng; Zhixin Shi; Xin Hong; Yufeng Qin; Genyan Liu

doi:10.2147/IDR.S410330

Characteristics of Virulent ST5-SCC mec II Methicillin-Resistant Staphylococcus aureus Prevalent in a Surgery Ward

Infect Drug Resist. 2023 Jun 2:16:3487-3495. doi: 10.2147/IDR.S410330. eCollection 2023.

Authors

Lei Huang^{1

2}, Chengcheng Liu^{1

2}, Zhanjie Li³, Xu Huang^{1

4}, Ruiying Zheng^{1

2}, Zhixin Shi^{1

2}, Xin Hong^{1

2}, Yufeng Qin⁵, Genyan Liu^{1

2}

Affiliations

¹ Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
² Branch of National Clinical Research Center for Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
³ Department of Infection Control, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
⁴ Department of Laboratory Medicine, the Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.
⁵ School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China.

Abstract

Objective: To investigate the transmission pathway of a MRSA prevalence in a pancreatic surgery ward in a Chinese teaching hospital.

Methods: Molecular epidemiology investigations were carried out combined PFGE, MLST, SCCmec typing and whole-genome sequencing for 20 successive MRSA isolates (2 isolates from the ward environment). Resistance and virulence genes were detected using specific PCR. Bacterial identification and AST were performed using the Vitek 2 Compact System. Clinical data of enrolled cases were retrieved from electronic case records.

Results: From January 2020 to May 2020, successive isolated 20 MRSA strains were clarified to 2 PFGE patterns (A = 19, B = 1) in the ward. Both isolates from environment and patients belonged to sequence type ST5-SCCmec II-spa type t311. MRSA-related resistance genes mecA, blaZ, ermA, ant(4')-Ia and norA were found in each clone. All 20 isolates carried tst, hlg, hla, eta, eap, fnbA and seo virulence genes, other virulence genes such as sea, sec, seb, seg, sei, sem, sen, ebpS and fnbB were also found in partial stains. All patients had fever symptom, 27.8% were accompanied by diarrhea, 88.9% had undergone surgery or invasive procedures within 30 days. Finally, 94.4% of these patients recovered.

Conclusion: This study confirmed a prevalence of ST5-MRSA-II-t311 clone in a surgery ward, indicated MRSA is a risk factor for post-surgery nosocomial infection and hand hygiene and environmental surveillance should not be ignored.

Keywords: SCCmec II; ST5; diarrhea; methicillin-resistantStaphylococcus aureus; spa type t311; virulence genes.