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Genotyping of methicillin-resistant Staphylococcus aureus from sepsis patients in Pakistan and detection of antibodies against staphylococcal virulence factors

  • Stefan MoneckeEmail author
  • Muhammad Ali Syed
  • Mushtaq Ahmad Khan
  • Shehzad Ahmed
  • Sadia Tabassum
  • Darius Gawlik
  • Elke Müller
  • Annett Reissig
  • Sascha D. Braun
  • Ralf Ehricht
Original Article

Abstract

In order to obtain more information on the MRSA population structure in the border region of Afghanistan and Pakistan, we collected and genotyped MRSA causing bloodstream infections from a tertiary care hospital in Peshawar, Pakistan, that serves the local population as well as Afghan immigrants and refugees. Thirty-one MRSA isolates from 30 patients were included and characterized by microarray hybridisation. For 25 patients, serum samples were tested using protein microarrays in order to detect antibodies against staphylococcal virulence factors. The most conspicuous result was the high rate of PVL-positive MRSA. Twenty-two isolates (71%) harboured lukF/S-PV genes. The most common lineage was CC772-MRSA-V/VT (PVL+) to which eleven isolates were assigned. The second most common strain was, surprisingly, CC8-MRSA-[IV+ACME] (PVL+), “USA300” (9 isolates). Two isolates were tst1 positive CC22-MRSA-IV, matching the Middle Eastern “Gaza Epidemic Strain”. Another two were PVL-positive CC30-MRSA-IV. The remaining isolates belonged to, possibly locally emerging, CC1, CC5, and CC8 strains with SCC mec IV elements. Twenty-three patient sera were positive for anti-PVL-IgG antibodies. Several questions arise from the present study. It can be assumed that MRSA and high rates of PVL-positive S. aureus/MRSA are a public health issue in the Afghanistan/Pakistan border region. A possible emergence of the “USA300” clone as well as of the CC772 lineage warrants further investigation.

Keywords

Staphylococcus aureus MRSA mecPVL 

Notes

Acknowledgments

The authors thank Peter Slickers (Abbott/Alere Jena) for bioinformatic work designing the microarrays used for the present study. We would like to acknowledge the staff of Lady Reading Hospital Peshawar for their cooperation in sample collection.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10096_2019_3695_MOESM1_ESM.pdf (1 mb)
Supplemental file 1 Full genotyping data. (PDF 1065 kb)
10096_2019_3695_MOESM2_ESM.pdf (268 kb)
Supplemental file 2A Full serological data (direct assay). (PDF 267 kb)
10096_2019_3695_MOESM3_ESM.pdf (263 kb)
Supplemental file 2B Full serological data (indirect assay). (PDF 263 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Stefan Monecke
    • 1
    • 2
    • 3
    Email author
  • Muhammad Ali Syed
    • 4
  • Mushtaq Ahmad Khan
    • 5
  • Shehzad Ahmed
    • 5
  • Sadia Tabassum
    • 6
  • Darius Gawlik
    • 7
  • Elke Müller
    • 1
    • 2
  • Annett Reissig
    • 1
    • 2
  • Sascha D. Braun
    • 1
    • 2
  • Ralf Ehricht
    • 1
    • 2
  1. 1.Leibniz Institute of Photonic Technology (IPHT)JenaGermany
  2. 2.InfectoGnostics Research Campus JenaJenaGermany
  3. 3.Institute for Medical Microbiology and Hygiene, Medical Faculty “Carl Gustav Carus”Technische Universität DresdenDresdenGermany
  4. 4.Department of MicrobiologyThe University of HaripurHaripurPakistan
  5. 5.Department of MicrobiologyHazara University MansehraMansehraPakistan
  6. 6.Department of ZoologyHazara University MansehraMansehraPakistan
  7. 7.PTC - Phage Technology Center GmbHBönenGermany

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