TY - JOUR
T1 - Markers of epidemiological success of methicillin-resistant Staphylococcus aureus isolates in European populations
AU - Baede, Valérie O.
AU - Gupta, Arya
AU - Knight, Gwenan M.
AU - Schouls, Leo M.
AU - Laing, Ken
AU - Tavakol, Mehri
AU - Barray, Anaïs
AU - de Vlas, Sake J.
AU - de Vos, Anneke S.
AU - Hendrickx, Antoni P.A.
AU - Khan, Madeeha
AU - Kretzschmar, Mirjam E.
AU - van Wamel, Willem J.B.
AU - Lina, Gérard
AU - Vandenesch, Francois
AU - Vos, Margreet C.
AU - Witney, Adam A.
AU - Rasigade, Jean Philippe
AU - Lindsay, Jodi A.
N1 - Funding Information:
The MACOTRA (Combating MRSA; increasing our understanding of transmission success will lead to better control of MRSA) study was supported by JPIAMR 3 rd call AMR Transmission dynamics, UK Medical Research Council grant MR/P028322/1 , French ANR Grant 16-JPEC-000 and Dutch ZonMw grant 547001006 .
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/9
Y1 - 2023/9
N2 - Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) infections impose a considerable burden on health systems, yet there is remarkable variation in the global incidence and epidemiology of MRSA. The MACOTRA consortium aimed to identify bacterial markers of epidemic success of MRSA isolates in Europe using a representative MRSA collection originating from France, the Netherlands and the United Kingdom. Methods: Operational definitions of success were defined in consortium meetings to compose a balanced strain collection of successful and sporadic MRSA isolates. Isolates were subjected to antimicrobial susceptibility testing and whole-genome sequencing; genes were identified and phylogenetic trees constructed. Markers of epidemiological success were identified using genome-based time-scaled haplotypic density analysis and linear regression. Antimicrobial usage data from ESAC-Net was compared with national MRSA incidence data. Results: Heterogeneity of MRSA isolate collections across countries hampered the use of a unified operational definition of success; therefore, country-specific approaches were used to establish the MACOTRA strain collection. Phenotypic antimicrobial resistance varied within related MRSA populations and across countries. In time-scaled haplotypic density analysis, fluoroquinolone, macrolide and mupirocin resistance were associated with MRSA success, whereas gentamicin, rifampicin and trimethoprim resistance were associated with sporadicity. Usage of antimicrobials across 29 European countries varied substantially, and β-lactam, fluoroquinolone, macrolide and aminoglycoside use correlated with MRSA incidence. Discussion: Our results are the strongest yet to associate MRSA antibiotic resistance profiles and antibiotic usage with the incidence of infection and successful clonal spread, which varied by country. Harmonized isolate collection, typing, resistance profiling and alignment with antimicrobial usage over time will aid comparisons and further support country-specific interventions to reduce MRSA burden.
AB - Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) infections impose a considerable burden on health systems, yet there is remarkable variation in the global incidence and epidemiology of MRSA. The MACOTRA consortium aimed to identify bacterial markers of epidemic success of MRSA isolates in Europe using a representative MRSA collection originating from France, the Netherlands and the United Kingdom. Methods: Operational definitions of success were defined in consortium meetings to compose a balanced strain collection of successful and sporadic MRSA isolates. Isolates were subjected to antimicrobial susceptibility testing and whole-genome sequencing; genes were identified and phylogenetic trees constructed. Markers of epidemiological success were identified using genome-based time-scaled haplotypic density analysis and linear regression. Antimicrobial usage data from ESAC-Net was compared with national MRSA incidence data. Results: Heterogeneity of MRSA isolate collections across countries hampered the use of a unified operational definition of success; therefore, country-specific approaches were used to establish the MACOTRA strain collection. Phenotypic antimicrobial resistance varied within related MRSA populations and across countries. In time-scaled haplotypic density analysis, fluoroquinolone, macrolide and mupirocin resistance were associated with MRSA success, whereas gentamicin, rifampicin and trimethoprim resistance were associated with sporadicity. Usage of antimicrobials across 29 European countries varied substantially, and β-lactam, fluoroquinolone, macrolide and aminoglycoside use correlated with MRSA incidence. Discussion: Our results are the strongest yet to associate MRSA antibiotic resistance profiles and antibiotic usage with the incidence of infection and successful clonal spread, which varied by country. Harmonized isolate collection, typing, resistance profiling and alignment with antimicrobial usage over time will aid comparisons and further support country-specific interventions to reduce MRSA burden.
KW - Antimicrobial resistance
KW - Antimicrobial usage
KW - Epidemiology
KW - MRSA
KW - Success
KW - Whole-genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85160860334&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2023.05.015
DO - 10.1016/j.cmi.2023.05.015
M3 - Article
C2 - 37207981
AN - SCOPUS:85160860334
SN - 1198-743X
VL - 29
SP - 1166
EP - 1173
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 9
ER -