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Clinical and molecular characteristics of Staphylococcus aureus isolated from Chinese children: association among the agr groups and genotypes, virulence genes and disease types

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Abstract

Background

This study was aimed to investigate the clinical and molecular epidemiology of Staphylococcus aureus (S. aureus) isolated from Chinese children and determine the possible relationship among the accessory gene regulator (agr) groups and genotypes, as well as among the virulence genes and disease types.

Methods

S. aureus strains were isolated from Beijing Children’s Hospital between October 2017 and October 2019. The isolates and 19 virulence genes were characterized using multi-locus sequence typing, staphylococcal protein A (spa), staphylococcal cassette chromosome mec, and agr typing.

Results

A total of 191 non-repetitive S. aureus clinical isolates were divided into 33 sequence types (STs), 18 clonal complexes (CCs), and 59 spa types. ST59 (39.8%), t437 (37.7%), and agr I (84.8%) were the predominant types. CC59, CC25, CC22, CC951, CC8, and CC398 belonged to agr I. CC5 and CC15 were assigned to agr II, and CC30 was characterized as agr III. CC121 was classified under agr IV. The eta, etb, and bbp genes were more prevalent in agr IV (P < 0.001 for each), while tst was more prevalent in agr group III compared to the other groups (P < 0.001). Nearly all isolates that harbored lukS/F-PV belonged to agr I (P = 0.005). However, the correlation between disease types and agr groups was not significant (P > 0.05).

Conclusions

An association among the agr groups and genotypes, as well as specific toxin genes, was observed among the S. aureus strains isolated from Chinese children. However, a statistical correlation was not found among the agr groups and disease types.

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Acknowledgements

We thank the research group of Xu-Zhuang Shen, who worked in Beijing Pediatric Research Institute in China, for supplying the Staphylococcus aureus standard strains used in this study.

Funding

This study was funded by the Beijing Natural Science Foundation (No. 7172075) and the National Natural Science Foundation of China (No. 81571948). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, No.56 Nan-Li-Shi Road, Beijing, 100045, China

    Yan Xu, Su-Yun Qian, Chen Sun & Xin Yang

  2. Key Laboratory of Major Diseases in Children, Ministry of Education, National Key Discipline of Pediatrics (Capital Medical University), National Center for Children’s Health, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045, China

    Kai-Hu Yao

  3. Bacteriology Laboratory, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, 100045, China

    Fang Dong, Wen-Qi Song, Jing- Hui Zhen, Xi-Qing Liu, Zhi -Yong Lv & Xi Yang

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  1. Yan Xu
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Contributions

XY collected the medical records, performed agr, MLST, SCCmec and spa typing, detected the virulence genes, analyzed the data, and drafted the manuscript. QSY designed the study and revised the article. YKH statistically analyzed the data and revised the article. DF, SWQ and YX revised the article. SC performed MLST and spa typing. ZJH, LXQ, LZY, and YX collected and identified the clinical strains of S. aureus. All authors had read and approved the final manuscript.

Corresponding author

Correspondence to Su-Yun Qian.

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Ethical approval

The bacterial isolates used in this study were isolated from the biological specimens obtained during the management of patients, with no threat to the subjects’ rights and health. The applications for the exemption of written informed content and ethical review were approved by the Ethics Committee of Beijing Children’s Hospital Affiliated to Capital Medical University according to national regulations (No. 2016–93, 23/06/2016). Verbal consent was obtained from the parents or legal guardians of the patients. This study also obtained clearance from the Institutional Biosafety Committee (IBSC) (2017, No. 43).

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The authors declare that they have no conflict of interest.

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Xu, Y., Qian, SY., Yao, KH. et al. Clinical and molecular characteristics of Staphylococcus aureus isolated from Chinese children: association among the agr groups and genotypes, virulence genes and disease types. World J Pediatr 17, 180–188 (2021). https://doi.org/10.1007/s12519-021-00421-4

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