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Molecular epidemiology of hospital-onset methicillin-resistant Staphylococcus aureus infections in Southern Chile

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen of public health importance. In Chile, the Cordobes/Chilean clone was the predominant healthcare-associated MRSA (HA-MRSA) clone in 1998. Since then, the molecular epidemiological surveillance of MRSA has not been performed in Southern Chile. We aimed to investigate the molecular epidemiology of HA-MRSA infections in Southern Chile to identify the MRSA clones involved, and their evolutionary relationships with epidemic international MRSA lineages. A total of 303 single inpatient isolates of S. aureus were collected in the Valdivia County Hospital (2007–2008), revealing 33 % (100 MRSA/303) prevalence for HA-MRSA infections. The SCCmec types I and IV were identified in 97 % and 3 % of HA-MRSA, respectively. All isolates lacked the pvl genes. A random sample (n = 29) of all MRSA was studied by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), SCCmec subtyping, agr and spa typing, and virulence genes profiling. PFGE analysis revealed the predominance (89 %, 26/29) of pulsotype A and three additional pulsotypes, designated H1, I33, and G1. Pulsotype A (ST5-SCCmecI-spa-t149) is clonally related to the Cordobes/Chilean clone. Pulsotype H1 (ST5-SCCmecIVNT-spa-t002) is genetically related to the Pediatric clone (ST5-SCCmecIV). Pulsotype I33 (ST5-SCCmecIVc-spa-t002) is clonally related by PFGE to the community-associated MRSA (CA-MRSA) clone spread in Argentina, I-ST5-IVa-PVL+. The G1 pulsotype (ST8-SCCmecIVc-spa-t024) is clonally related to the epidemic USA300 CA-MRSA. Here, we demonstrate the stability of the Cordobes/Chilean clone over time as the major HA-MRSA clone in Southern Chile. The identification of two CA-MRSA clones might suggest that these clones have entered into the healthcare setting from the community. These results emphasize the importance of the local surveillance of MRSA infections in the community and hospital settings.

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Acknowledgments

We thank all the staff of the Microbiology Section of the County Hospital of Valdivia Central Laboratory. Thanks also go to Ruby Hernández, María Emilia Arce, Angela Zaror, and Carolina Cruz.

Funding

Dirección de Investigación y Desarrollo–S2010-02 Universidad Austral de Chile. The National Council for Scientific Research and Technology of Argentina (CONICET-PIP-2009-2011 to CS), Agencia Nacional de Promoción Científica y Tecnológica, Argentina (ANPCyT–PICT 07–01630 to J.L.B.), and Secretaría de Ciencia y Técnica–Universidad Nacional de Córdoba, Argentina (SECyT-UNC). C.S. and J.L.B. are career investigator members of CONICET. A.L.E. is a fellow recipient of the ANPCyT.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Instituto de Microbiología Clínica, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile

    G. Medina, C. Otth, L. Otth, H. Fernández & M. Wilson

  2. Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI—CONICET), Departamento de Bioquímica Clínica, Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre y M. Allende s/n Ciudad Universitaria, 5000, Córdoba, Argentina

    A. L. Egea, J. L. Bocco & C. Sola

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  1. G. Medina
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  2. A. L. Egea
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Correspondence to M. Wilson or C. Sola.

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G. Medina and A. L. Egea contributed equally to this work.

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Medina, G., Egea, A.L., Otth, C. et al. Molecular epidemiology of hospital-onset methicillin-resistant Staphylococcus aureus infections in Southern Chile. Eur J Clin Microbiol Infect Dis 32, 1533–1540 (2013). https://doi.org/10.1007/s10096-013-1907-8

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