Sains Malaysiana 44(9)(2015): 1315–1323
Clonal
Diversity of Methicillin-resistant Staphylococcus aureus in UKM Medical Centre: Characterisation by Multilocus Sequence
Typing of Different SCCmec Type Representatives
(Kepelbagaian
Klon Staphylococcus aureus Rintang Methicillin di Pusat Perubatan
UKM: Pencirian Molekul Menggunakan Penjenisan
Jujukan Multilokus terhadap Wakil Jenis SCCmec yang
Berlainan)
NAJIHAN ABDUL
SAMAT
MUTTAQILLAH 1*, SALASAWATI
HUSSIN1,
HUI-MIN,
NEOH2,
AINIHAYATI
NOORDIN1,
CHUAN HUN DING1,
ASRUL
ABDUL
WAHAB1
& MD MOSTAFIZUR RAHMAN1
1Department of Medical
Microbiology and Immunology, Universiti Kebangsaan Malaysia Medical Centre, Universiti
Kebangsaan Malaysia, 56000 Kuala Lumpur, Wilayah Persekutuan, Malaysia
2UKM
Medical Molecular Biology Institute, Universiti Kebangsaan Malaysia Medical
Centre
Universiti
Kebangsaan Malaysia, 56000 Kuala Lumpur, Wilayah Persekutuan, Malaysia
Received:
22 May 2014/Accepted: 15 May 2015
ABSTRACT
Multilocus sequence typing (MLST) has been used to characterise
methicillin-resistant Staphylococcus aureus (MRSA) isolates into sequence types
(STs) and together with SCCmec
typing, form the clonal nomenclature for MRSA. MLST was
conducted as per the standard protocol on ten out of 236 isolates
collected previously from January to December 2009 representing
four different SCCmec
types. Relationship analysis was performed with eBURST via
the MLST website. Four unlinked ‘singleton’ STs
were detected: ST30, ST239,
ST772
and ST1178. Together with SCCmec
typing, five MRSA clones were identified: ST30-IV,
ST239-II,
ST239-III,
ST772-V
and ST1178-IV. Clones ST239-III and ST30-IV
are already established in Malaysian hospitals and in the local
community, respectively. ST772-V is an emerging clone reported previously to have
a propensity to displace pre-existing predominant clones. A clone
involving the predominant ST in Malaysia (ST239) with SCCmec
type II is the first of its kind to be identified. MRSA clones
in our centre are very diverse and clone surveillance with large
sample sizes should be undertaken as collaborative efforts between
local institutions to maximise detection coverage.
Keywords: Methicillin-resistant Staphylococcus aureus (MRSA); molecular characterisation;
multilocus sequence typing (MLST);
Staphylococcal cassette chromosome mec (SCCmec)
ABSTRAK
Penjenisan jujukan multilokus (MLST)
membolehkan isolat Staphylococcus aureus rintang methicilin
(MRSA) dicirikan kepada jenis-jenis jujukan (ST)
tertentu. Apabila digabungkan dengan jenis jujukan
SCCmec
masing-masing, tatanama antarabangsa bagi klon-klon MRSA ini
dapat dibentuk. Kajian MLST dijalankan mengikut protokol
piawai ke atas sepuluh daripada 236 isolat MRSA terpilih
yang dikumpul dari bulan Januari hingga Disember 2009 dengan setiap
isolat mewakili empat jenis SCCmec yang berbeza. Hubungan antara isolat tersebut dikaji menggunakan eBURST melalui
laman sesawang MLST. Empat
jujukan tunggal ST yang tidak berkait telah dikenal pasti
iaitu ST30, ST239, ST772
dan ST1178. Bersama-sama pencirian jujukan SCCmec
masing-masing, lima klon telah dikenal
pasti, iaitu ST30-IV,
ST239-II,
ST239-III, ST772-V dan ST1178-IV. Klon-klon
ST239-III
dan ST30-IV telahpun diketahui bertapak di hospital-hospital
di Malaysia (ST239-III) dan juga di dalam komuniti (ST30-IV).
Klon ST772-V adalah klon yang dikenal pasti
sebagai klon yang baru muncul dan berkebolehan untuk menggantikan
klon paling dominan sedia ada. Klon baru
yang melibatkan ST paling
dominan di Malaysia (ST239) dengan jujukan SCCmec
jenis II telah ditemui buat kali pertama. Kami
mendapati pelbagai klon MRSA dipencilkan di hospital kami.
Oleh itu, kami menyarankan supaya pengawasan yang berterusan melibatkan
saiz sampel yang lebih besar perlu dijalankan dengan kerjasama dari
institusi tempatan yang lain bagi memaksimumkan liputan pengesanan.
Kata kunci: Kromosom kaset
mec stafilokokal
(SCCmec);
penjenisan jujukan multilokus (MLST); pencirian
molekul; Staphylococcus aureus rintang meticillin (MRSA)
REFERENCES
Afroz, S., Kobayashi, N., Nagashima, S., Alam,
M.M., Hossain, A.B., Rahman, M.A., Islam, M.R., Lutfor, A.B., Muazzam, N.,
Khan, M.A., Paul, S.K., Shamsuzzaman, A.K., Mahmud, M.C., Musa, A.K. &
Hossain, M.A. 2008. Genetic characterization of Staphylococcus aureus isolates
carrying Panton-Valentine leukocidin genes in Bangladesh. Jpn. J. Infect.
Dis. 61(5): 393-396.
Ahmad, N., Ruzan, I.N., Abd
Ghani, M.K., Hussin, A., Nawi, S., Aziz, M.N., Maning, N. & Eow, V.L. 2009. Characteristics of community- and
hospital-acquired methicillin-resistant Staphylococcus aureus strains
carrying SCCmec type IV isolated in Malaysia. J. Med. Microbiol.
58: 1213-1218.
Ainihayati Noordin. 2010. Personal
Communication.
Boyle-Vavra, S. & Daum,
R.S. 2007. Community-acquired
methicillin-resistant Staphylococcus aureus: The role of
Panton-Valentine leukocidin. Lab. Invest. 87(1): 3-9.
Brennan, G.I., Shore, A.C.,
Corcoran, S., Tecklenborg, S., Coleman, D.C. & O’Connell, B. 2012. Emergence of hospital-and community-associated
Panton-Valentine leukocidin positive methicillin-resistant Staphylococcus
aureus genotype ST772-MRSA-V in Ireland and detailed investigation of a ST772-MRSA-V cluster in a neonatal intensive care unit. J.
Clin. Microbiol. 50(3): 841-847.
Chambers, H.F. 1997. Methicillin resistance in
staphylococci: Molecular and biochemical basis and clinical implications.
Clin. Microbiol. Rev. 10(4): 781-791.
Chongtrakool, P., Ito, T., Ma, X.X., Kondo, Y.,
Trakulsomboon, S., Tiensasitorn, C., Jamklang, M., Chavalit, T., Song, J.H.
& Hiramatsu, K. 2006. Staphylococcal cassette chromosome mec (SCCmec)
typing of methicillin-resistant Staphylococcus aureus strains isolated
in 11 Asian countries: A proposal for a new nomenclature for SCCmec elements. Antimicrob. Agents Chemother. 50(3): 1001-1012.
D'Souza, N., Rodrigues, C.
& Mehta, A. 2010. Molecular
characterization of methicillin-resistant Staphylococcus aureus
with emergence of epidemic clones of sequence type (ST) 22 and
ST772 in Mumbai, India. J. Clin. Microbiol. 48(5): 1806-1811.
Enright, M.C., Day, N.P.,
Davies, C.E., Peacock, S.J. & Spratt, B.G. 2000. Multilocus sequence typing
for characterization of methicillin-resistant and methicillin-susceptible
clones of Staphylococcus aureus. J. Clin. Microbiol. 38(3):
1008-1015.
Enright, M.C., Robinson,
D.A., Randle, G., Feil, E.J., Grundmann, H. & Spratt, B.G. 2002. The evolutionary history of
methicillin-resistant Staphylococcus aureus (MRSA). Proc.
Natl. Acad. Sci. USA 99(11): 7687-7692.
Faria, N.A., Carrico, J.A.,
Oliveira, D.C., Ramirez, M. & de Lencastre, M. 2008. Analysis of typing methods
for epidemiological surveillance of both methicillin-resistant and
methicillin-susceptible Staphylococcus aureus strains. J.
Clin. Microbiol. 46(1): 136-144.
Fitzgerald, J.R.,
Sturdevant, D.E., Mackie, S.M., Gill, S.R. & Musser, J.M. 2001. Evolutionary genomics of Staphylococcus
aureus: Insights into the origin of methicillin-resistant strains and the
toxic shock syndrome epidemic. Proc. Natl. Acad. Sci. USA. 98(15):
8821-8826.
Ghaznavi-Rad, E., Nor Shamsudin, M., Sekawi, Z.,
Khoon, L.Y., Aziz, M.N., Hamat, R.A., Othman, N., Chong, P.P., van Belkum, A.,
Ghasemzadeh-Moghaddam, H. & Neela, V. 2010. Predominance
and emergence of clones of hospital-acquired methicillin-resistant Staphylococcus
aureus in Malaysia. J. Clin. Microbiol. 48(3): 867-872.
Hiramatsu, K., Cui, L.,
Kuroda, M. & Ito, T. 2001. The emergence and evolution of
methicillin-resistant Staphylococcus aureus. Trends Microbiol.
9(10): 486-493.
Huang, Y.H., Tseng, S.P., Hu, J.M.,
Tsai, J.C., Hsueh, P.R. & Teng, L.J. 2007. Clonal spread of SCCmec type IV methicillin- resistant Staphylococcus aureus between community and hospital. Clin.
Microbiol. Infect. 13(7): 717-724.
International
Working Group on the Classification of Staphylococcal Cassette Chromosome (SCC)
Elements. 2013. Currently identified SCCmec types in S. aureus strains.
http://www.sccmec.org/Pages/SCC_TypesEN.html. Accessed on 23 December 2012.
Ito, T., Katayama, Y., Asada, K., Mori, N., Tsutsumimoto,
K., Tiensasitorn, C. & Hiramatsu, K. 2001. Structural comparison of three types of staphylococcal cassette chromosome mec integrated in the chromosome in methicillin-resistant Staphylococcus
aureus. Antimicrob. Agents Chemother. 45(5): 1323-1336.
Ko,
K.S., Lee, J.Y., Suh, J.Y., Oh, W.S., Peck, K.R., Lee, N.Y. & Song, J.H. 2005. Distribution of major genotypes among
methicillin-resistant Staphylococcus aureus clones in Asian countries. J.
Clin. Microbiol. 43(1): 421-426.
Ma, X.X., Ito, T., Chongtrakool, P. & Hiramatsu, K. 2006. Predominance of clones carrying Panton-Valentine leukocidin
genes among methicillin-resistant Staphylococcus aureus strains
isolated in Japanese hospitals from 1979 to 1985. J. Clin. Microbiol.
44(12): 4515-4527.
Maiden,
M.C., Bygraves, J.A., Feil, E., Morelli, G., Russell, J.E., Urwin, R., Zhang,
Q., Zhou, J., Zurth, K., Caugant, D.A., Feavers, I.M., Achtman, M. &
Spratt, B.G. 1998. Multilocus sequence typing: A portable approach to the
identification of clones within populations of pathogenic microorganisms. Proc.
Natl. Acad. Sci. USA 95(6): 3140-3145.
McDougal,
L.K. & Thornsberry, C. 1986. The role of beta-lactamase
in staphylococcal resistance to penicillinase-resistant penicillins and
cephalosporins. J. Clin. Microbiol. 23(5): 832-839.
Musser, J.M. & Kapur, V. 1992. Clonal analysis of methicillin-resistant Staphylococcus aureus strains
from intercontinental sources: Association of the mec gene with
divergent phylogenetic lineages implies dissemination by horizontal transfer
and recombination. J. Clin. Microbiol. 30(8): 2058- 2063.
Neela,
V., Ghasemzadeh Moghaddam, H., van Belkum, A., Horst-Kreft, D., Mariana, N.S.
& Ghaznavi-Rad, E. 2010. First report on methicillin-resistant Staphylococcus
aureus of Spa type t037, sequence type 239, SCCmec type III/IIIA in
Malaysia. Eur. J. Clin. Microbiol. Infect. Dis. 29(1): 115-117.
Neela, V., Ehsanollah, G.R., Zamberi, S., val Belkum, A.
& Mariana, N.S. 2009. Prevalence of Panton-Valentine
leukocidin genes among carriage and invasive Staphylococcus aureus isolates
in Malaysia. Int. J. Infect. Dis. 13(3): e131-e132.
Saunders,
N.A. & Holmes, A. 2007. Multilocus sequence typing (MLST)
of Staphylococcus aureus. Methods Mol. Biol. 391: 71-85.
Shore,
A.C., Rossney, A.S., Kinnevey, P.M., Brennan, O.M., Creamer, E., Sherlock, O.,
Dolan, A., Cunney, R., Sullivan, D.J., Goering, R.V., Humphreys, H. &
Coleman, D.C. 2010. Enhanced discrimination of highly clonal
ST22-methicillin-resistant Staphylococcus aureus IV isolates achieved by
combining spa, dru, and pulsed-field gel electrophoresis typing data. J.
Clin. Microbiol. 48(5): 1839-1852.
Tomasz, A., Drugeon, H.B., de Lencastre, H.M., Jabes, D.,
McDougoull, L. & Billie, J. 1989. New mechanism for
methicillin resistance in Staphylococcus aureus: Clinical isolates that
lack the PBP2a gene and contain normal penicillin-binding proteins with
modified penicillin-binding capacity. Antimicrob. Agents Chemother.
33(11): 1869-1874.
Wang,
S.H., Khan, Y., Hines, L., Mediavilla, J.R., Zhang, L., Chen, L., Hoet, A.,
Bannerman, T., Pancholi, P., Robinson, D.A., Kreiswirth, B.N., Stevenson, K.B.
& Prevention Epicenter Program of the Centers for Disease Control and
Prevention. 2012. Methicillin-resistant Staphylococcus aureus sequence
type 239-III, Ohio, USA, 2007-2009. Emerg. Infect. Dis. 18(10):
1557-1565.
*Corresponding
author; email: muttaqillah@ppukm.ukm.edu.my
|