Origin and evolution of European community-acquired methicillin-resistant Staphylococcus aureus

Authors

Marc Stegger, Statens Serum Institut, Copenhagen, DenmarkFollow
Thierry Wirth, Ecole Pratique des Hautes Etudes, Paris, France
Paal S. Andersen, Statens Serum Institut, Copenhagen, Denmark
Robert L. Skov, Statens Serum Institut, Copenhagen, Denmark
Anna De Grassi, Muséum National d'Histoire Naturelle, Paris, France
Lance B. Price, George Washington UniversityFollow
+23 additional authors

Document Type

Journal Article

Publication Date

8-26-2014

Journal

mBio

Volume

Volume 5, Issue 5

Inclusive Pages

e01044-14

Abstract

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was recognized in Europe and worldwide in the late 1990s. Within a decade, several genetically and geographically distinct CA-MRSA lineages carrying the small SCCmec type IV and V genetic elements and the Panton-Valentine leukocidin (PVL) emerged around the world. In Europe, the predominant CA-MRSA strain belongs to clonal complex 80 (CC80) and is resistant to kanamycin/amikacin and fusidic acid. CC80 was first reported in 1993 but was relatively rare until the late 1990s. It has since been identified throughout North Africa, the Middle East, and Europe, with recent sporadic reports in sub-Saharan Africa. While strongly associated with skin and soft tissue infections, it is rarely found among asymptomatic carriers. Methicillin-sensitive S. aureus (MSSA) CC80 strains are extremely rare except in sub-Saharan Africa. In the current study, we applied whole-genome sequencing to a global collection of both MSSA and MRSA CC80 isolates. Phylogenetic analyses strongly suggest that the European epidemic CA-MRSA lineage is derived from a PVL-positive MSSA ancestor from sub-Saharan Africa. Moreover, the tree topology suggests a single acquisition of both the SCCmec element and a plasmid encoding the fusidic acid resistance determinant. Four canonical SNPs distinguish the derived CA-MRSA lineage and include a nonsynonymous mutation in accessory gene regulator C (agrC). These changes were associated with a star-like expansion into Europe, the Middle East, and North Africa in the early 1990s, including multiple cases of cross-continent imports likely driven by human migrations.

Comments

Reproduced with permission of mBio.

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 License.

APA Citation

Stegger, M., Wirth, T., Andersen, P.S., Skov, R.L., De Grassi, A. et al. (2014). Origin and evolution of European community-acquired methicillin-resistant Staphylococcus aureus. mBio, 5(5):e01044-14.

Peer Reviewed

1

Open Access

1