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- Title
Molecular Epidemiology, Antimicrobial Susceptibility, and Clinical Features of Methicillin-Resistant Staphylococcus aureus Bloodstream Infections over 30 Years in Barcelona, Spain (1990–2019).
- Authors
Vázquez-Sánchez, Daniel Antonio; Grillo, Sara; Carrera-Salinas, Anna; González-Díaz, Aida; Cuervo, Guillermo; Grau, Inmaculada; Camoez, Mariana; Martí, Sara; Berbel, Dàmaris; Tubau, Fe; Ardanuy, Carmen; Pujol, Miquel; Càmara, Jordi; Domínguez, Mª Ángeles
- Abstract
Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) are a significant cause of mortality. We analysed the evolution of the molecular and clinical epidemiology of MRSA-BSI (n = 784) in adult patients (Barcelona, 1990–2019). Isolates were tested for antimicrobial susceptibility and genotyped (PFGE), and a selection was sequenced (WGS) to characterise the pangenome and mechanisms underlying antimicrobial resistance. Increases in patient age (60 to 71 years), comorbidities (Charlson's index > 2, 10% to 94%), community-onset healthcare-associated acquisition (9% to 60%), and 30-day mortality (28% to 36%) were observed during the 1990–1995 and 2014–2019 periods. The proportion of catheter-related BSIs fell from 57% to 20%. Current MRSA-BSIs are caused by CC5-IV and an upward trend of CC8-IV and CC22-IV clones. CC5 and CC8 had the lowest core genome proportions. Antimicrobial resistance rates fell, and only ciprofloxacin, tobramycin, and erythromycin remained high (>50%) due to GyrA/GrlA changes, the presence of aminoglycoside-modifying enzymes (AAC(6′)-Ie-APH(2″)-Ia and ANT(4′)-Ia), and mph(C)/msr(A) or erm (C) genes. Two CC22-IV strains showed daptomycin resistance (MprF substitutions). MRSA-BSI has become healthcare-associated, affecting elderly patients with comorbidities and causing high mortality rates. Clonal replacement with CC5-IV and CC8-IV clones resulted in lower antimicrobial resistance rates. The increased frequency of the successful CC22-IV, associated with daptomycin resistance, should be monitored.
- Subjects
BARCELONA (Spain); STAPHYLOCOCCUS aureus infections; METHICILLIN-resistant staphylococcus aureus; COVID-19; MOLECULAR epidemiology; MICROBIAL sensitivity tests; DRUG resistance in microorganisms
- Publication
Microorganisms, 2022, Vol 10, Issue 12, p2401
- ISSN
2076-2607
- Publication type
Article
- DOI
10.3390/microorganisms10122401