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Emerging multidrug-resistant Bengal Bay clone ST772-MRSA-V in Norway: molecular epidemiology 2004–2014

  • A. BlomfeldtEmail author
  • K. W. Larssen
  • A. Moghen
  • C. Gabrielsen
  • P. Elstrøm
  • H. V. Aamot
  • S. B. Jørgensen
Original Article

Abstract

A multidrug-resistant, methicillin-resistant Staphylococcus aureus (MRSA) clone, PVL-positive ST772-MRSA-V, named the Bengal Bay clone, is emerging worldwide. In Norway, where MRSA prevalence is low, a sudden increase in ST772-MRSA-V initiated a nationwide molecular epidemiological study. Clinical data were obtained from the Norwegian Surveillance System for Communicable Diseases (MSIS). S. aureus isolates were characterised by antibiotic susceptibility profiles and comprehensive genotyping (spa typing, MLVA, DNA microarray). ST772-MRSA was detected in 145 individuals during 2004–2014, with 60% of cases occurring in 2013–2014. Median age was 31 years and male/female ratio 1.16. The majority had a family background from the Indian subcontinent (70%). MRSA acquisition was mainly reported as unknown (39%) or abroad (42%), the latter associated with a home-country visit (59%), tourism (16%), and immigration (13%). Clinical infection was present in 75%, predominantly by SSTI (83%), 18% were admitted to hospital and 42% were linked to small-scale outbreaks (n = 25). All isolates were multidrug-resistant. Most isolates were resistant to erythromycin, gentamicin and norfloxacin. Genotyping revealed a conserved clone predominated by spa type t657 (83%), MLVA-type 432 (67%) and the genes lukF/S, sea, sec/sel, egc, scn, cna, ccrAA/ccrC, agrII and cap5. A few untypical ccr gene combinations were detected. Bengal Bay isolates have likely been imported on several occasions and revision of infection control guidelines may prevent further spread.

Notes

Acknowledgements

We would like to thank Surendra Kumar Madhip (Dhulikel Hospital, Kathmandu University Hospital, Nepal), Gunnsteinn Haraldsson (Landspitali University Hospital, Reykjavik, Iceland) and Anders Rhod Larsen (Statens Serum Institut, Copenhagen, Denmark) for contributing control isolates. The authors thank Karin Helmersen (Akershus University Hospital) for technical assistance with spa typing and MLVA.

The work was carried out in Akershus University Hospital and the National Reference Laboratory for MRSA, St Olavs University Hospital.

Compliance with ethical standards

Funding

This research received no funding.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Norwegian Regional Ethics Committee South-East (2014/1710) and by the Data Protection Official at Akershus University Hospital (14-132).

Informed consent

Exemption from obtaining informed consent was given by the Norwegian Regional Ethics Committee South-East under Norwegian law due to use of health register data (MSIS).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Microbiology and Infection ControlAkershus University HospitalLørenskogNorway
  2. 2.National Reference Laboratory for MRSA, Department of Medical MicrobiologySt Olavs University HospitalTrondheimNorway
  3. 3.Department of Antibiotic Resistance and Infection PreventionNorwegian Institute of Public HealthOsloNorway
  4. 4.Department of Clinical Molecular Biology (EpiGen)Akershus University Hospital and University of OsloLørenskogNorway

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