A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece: ST80-IV epidemic?

E. Drougka, A. Foka, A. Liakopoulos, A. Doudoulakakis, E. Jelastopulu, V. Chini, A. Spiliopoulou, S. Levidiotou, T. Panagea, A. Vogiatzi, E. Lebessi, E. Petinaki, I. Spiliopoulou

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of both healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections. Severe MRSA infections have been associated with the virulence factor Panton-Valentine leukocidin (PVL). The aim of this study was to investigate susceptibility patterns, the presence of toxin genes, including that encoding PVL, and clonality among MRSA isolates collected from patients in Greece over a 12-year period. MRSA isolates were collected from January 2001 to December 2012 from six different hospitals. Antibiotic susceptibility was determined with the disk diffusion method and the Etest. The presence of the toxic shock syndrome toxin-1 gene (tst), the enterotoxin gene cluster (egc) and the PVL gene was tested with PCR. The genotypic characteristics of the strains were analysed by SCCmec and agr typing, and clonality was determined with pulsed-field gel electrophoresis and multilocus sequence typing. An increasing rate of MRSA among S. aureus infections was detected up to 2008. The majority of PVL-positive MRSA isolates belonged to a single clone, sequence type (ST)80-IV, which was disseminated both in the community and in hospitals, especially during the warmest months of the year. Carriage of tst was associated with ST30-IV, whereas egc was distributed in different clones. CA-MRSA isolates were recovered mainly from skin and soft tissue infections, whereas HA-MRSA isolates were associated with surgical and wound infections. During the period 2001-2012, ST80-IV predominated in the community and infiltrated the hospital settings in Greece, successfully replacing other PVL-positive clones. The predominance of ST239-III in HA-MRSA infections was constant, whereas new clones have also emerged. Polyclonality was statistically significantly higher among CA-MRSA isolates and isolates from adult patients.

Original languageEnglish
Pages (from-to)O796-O803
JournalClinical Microbiology and Infection
Volume20
Issue number11
DOIs
Publication statusPublished - 1 Nov 2014

Fingerprint

Greece
Methicillin-Resistant Staphylococcus aureus
Infection
Clone Cells
Enterotoxins
Community Hospital
Multigene Family
Surveys and Questionnaires
Disk Diffusion Antimicrobial Tests
Genes
Delivery of Health Care
Multilocus Sequence Typing
Surgical Wound Infection
Soft Tissue Infections
Pulsed Field Gel Electrophoresis
Virulence Factors
Cross Infection
Staphylococcus aureus
Panton-Valentine leukocidin
Anti-Bacterial Agents

Keywords

  • Clones
  • Epidemiology
  • Greece
  • Methicillin-resistant staphylococcus aureus
  • ST80-IV
  • Toxins

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Drougka, E., Foka, A., Liakopoulos, A., Doudoulakakis, A., Jelastopulu, E., Chini, V., ... Spiliopoulou, I. (2014). A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece: ST80-IV epidemic? Clinical Microbiology and Infection, 20(11), O796-O803. https://doi.org/10.1111/1469-0691.12624

A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece : ST80-IV epidemic? / Drougka, E.; Foka, A.; Liakopoulos, A.; Doudoulakakis, A.; Jelastopulu, E.; Chini, V.; Spiliopoulou, A.; Levidiotou, S.; Panagea, T.; Vogiatzi, A.; Lebessi, E.; Petinaki, E.; Spiliopoulou, I.

In: Clinical Microbiology and Infection, Vol. 20, No. 11, 01.11.2014, p. O796-O803.

Research output: Contribution to journalArticle

Drougka, E, Foka, A, Liakopoulos, A, Doudoulakakis, A, Jelastopulu, E, Chini, V, Spiliopoulou, A, Levidiotou, S, Panagea, T, Vogiatzi, A, Lebessi, E, Petinaki, E & Spiliopoulou, I 2014, 'A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece: ST80-IV epidemic?', Clinical Microbiology and Infection, vol. 20, no. 11, pp. O796-O803. https://doi.org/10.1111/1469-0691.12624
Drougka, E. ; Foka, A. ; Liakopoulos, A. ; Doudoulakakis, A. ; Jelastopulu, E. ; Chini, V. ; Spiliopoulou, A. ; Levidiotou, S. ; Panagea, T. ; Vogiatzi, A. ; Lebessi, E. ; Petinaki, E. ; Spiliopoulou, I. / A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece : ST80-IV epidemic?. In: Clinical Microbiology and Infection. 2014 ; Vol. 20, No. 11. pp. O796-O803.
@article{987bb8e6c01a4fb2ac5567e1bead57af,
title = "A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece: ST80-IV epidemic?",
abstract = "Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of both healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections. Severe MRSA infections have been associated with the virulence factor Panton-Valentine leukocidin (PVL). The aim of this study was to investigate susceptibility patterns, the presence of toxin genes, including that encoding PVL, and clonality among MRSA isolates collected from patients in Greece over a 12-year period. MRSA isolates were collected from January 2001 to December 2012 from six different hospitals. Antibiotic susceptibility was determined with the disk diffusion method and the Etest. The presence of the toxic shock syndrome toxin-1 gene (tst), the enterotoxin gene cluster (egc) and the PVL gene was tested with PCR. The genotypic characteristics of the strains were analysed by SCCmec and agr typing, and clonality was determined with pulsed-field gel electrophoresis and multilocus sequence typing. An increasing rate of MRSA among S. aureus infections was detected up to 2008. The majority of PVL-positive MRSA isolates belonged to a single clone, sequence type (ST)80-IV, which was disseminated both in the community and in hospitals, especially during the warmest months of the year. Carriage of tst was associated with ST30-IV, whereas egc was distributed in different clones. CA-MRSA isolates were recovered mainly from skin and soft tissue infections, whereas HA-MRSA isolates were associated with surgical and wound infections. During the period 2001-2012, ST80-IV predominated in the community and infiltrated the hospital settings in Greece, successfully replacing other PVL-positive clones. The predominance of ST239-III in HA-MRSA infections was constant, whereas new clones have also emerged. Polyclonality was statistically significantly higher among CA-MRSA isolates and isolates from adult patients.",
keywords = "Clones, Epidemiology, Greece, Methicillin-resistant staphylococcus aureus, ST80-IV, Toxins",
author = "E. Drougka and A. Foka and A. Liakopoulos and A. Doudoulakakis and E. Jelastopulu and V. Chini and A. Spiliopoulou and S. Levidiotou and T. Panagea and A. Vogiatzi and E. Lebessi and E. Petinaki and I. Spiliopoulou",
year = "2014",
month = "11",
day = "1",
doi = "10.1111/1469-0691.12624",
language = "English",
volume = "20",
pages = "O796--O803",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier Limited",
number = "11",

}

TY - JOUR

T1 - A 12-year survey of methicillin-resistant staphylococcus aureus infections in greece

T2 - ST80-IV epidemic?

AU - Drougka, E.

AU - Foka, A.

AU - Liakopoulos, A.

AU - Doudoulakakis, A.

AU - Jelastopulu, E.

AU - Chini, V.

AU - Spiliopoulou, A.

AU - Levidiotou, S.

AU - Panagea, T.

AU - Vogiatzi, A.

AU - Lebessi, E.

AU - Petinaki, E.

AU - Spiliopoulou, I.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of both healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections. Severe MRSA infections have been associated with the virulence factor Panton-Valentine leukocidin (PVL). The aim of this study was to investigate susceptibility patterns, the presence of toxin genes, including that encoding PVL, and clonality among MRSA isolates collected from patients in Greece over a 12-year period. MRSA isolates were collected from January 2001 to December 2012 from six different hospitals. Antibiotic susceptibility was determined with the disk diffusion method and the Etest. The presence of the toxic shock syndrome toxin-1 gene (tst), the enterotoxin gene cluster (egc) and the PVL gene was tested with PCR. The genotypic characteristics of the strains were analysed by SCCmec and agr typing, and clonality was determined with pulsed-field gel electrophoresis and multilocus sequence typing. An increasing rate of MRSA among S. aureus infections was detected up to 2008. The majority of PVL-positive MRSA isolates belonged to a single clone, sequence type (ST)80-IV, which was disseminated both in the community and in hospitals, especially during the warmest months of the year. Carriage of tst was associated with ST30-IV, whereas egc was distributed in different clones. CA-MRSA isolates were recovered mainly from skin and soft tissue infections, whereas HA-MRSA isolates were associated with surgical and wound infections. During the period 2001-2012, ST80-IV predominated in the community and infiltrated the hospital settings in Greece, successfully replacing other PVL-positive clones. The predominance of ST239-III in HA-MRSA infections was constant, whereas new clones have also emerged. Polyclonality was statistically significantly higher among CA-MRSA isolates and isolates from adult patients.

AB - Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of both healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) infections. Severe MRSA infections have been associated with the virulence factor Panton-Valentine leukocidin (PVL). The aim of this study was to investigate susceptibility patterns, the presence of toxin genes, including that encoding PVL, and clonality among MRSA isolates collected from patients in Greece over a 12-year period. MRSA isolates were collected from January 2001 to December 2012 from six different hospitals. Antibiotic susceptibility was determined with the disk diffusion method and the Etest. The presence of the toxic shock syndrome toxin-1 gene (tst), the enterotoxin gene cluster (egc) and the PVL gene was tested with PCR. The genotypic characteristics of the strains were analysed by SCCmec and agr typing, and clonality was determined with pulsed-field gel electrophoresis and multilocus sequence typing. An increasing rate of MRSA among S. aureus infections was detected up to 2008. The majority of PVL-positive MRSA isolates belonged to a single clone, sequence type (ST)80-IV, which was disseminated both in the community and in hospitals, especially during the warmest months of the year. Carriage of tst was associated with ST30-IV, whereas egc was distributed in different clones. CA-MRSA isolates were recovered mainly from skin and soft tissue infections, whereas HA-MRSA isolates were associated with surgical and wound infections. During the period 2001-2012, ST80-IV predominated in the community and infiltrated the hospital settings in Greece, successfully replacing other PVL-positive clones. The predominance of ST239-III in HA-MRSA infections was constant, whereas new clones have also emerged. Polyclonality was statistically significantly higher among CA-MRSA isolates and isolates from adult patients.

KW - Clones

KW - Epidemiology

KW - Greece

KW - Methicillin-resistant staphylococcus aureus

KW - ST80-IV

KW - Toxins

UR - http://www.scopus.com/inward/record.url?scp=84917674559&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84917674559&partnerID=8YFLogxK

U2 - 10.1111/1469-0691.12624

DO - 10.1111/1469-0691.12624

M3 - Article

C2 - 24750462

AN - SCOPUS:84917674559

VL - 20

SP - O796-O803

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 11

ER -