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Changing epidemiology of presumptive community-associated-methicillin-resistant Staphylococcus aureus in Slovenia in 2014-2015 compared to 2010

Urška Dermota
Urška Dermota
, 
Irena Grmek Košnik
Irena Grmek Košnik
, 
Sandra Janežič
Sandra Janežič
 und 
Maja Rupnik
Maja Rupnik
   | 18. Okt. 2020
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Article Category: Research Article
Online veröffentlicht: 18. Okt. 2020
Seitenbereich: 236 - 244
Eingereicht: 28. Jan. 2020
Akzeptiert: 16. Sept. 2020
DOI: https://doi.org/10.2478/sjph-2020-0030
Schlüsselwörter
© 2020 National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Distribution of CA-MRSA spa types circulating in Slovenia in 2014 and 2015.
Distribution of CA-MRSA spa types circulating in Slovenia in 2014 and 2015.

Figure 2

The distribution of presumptive CA-MRSA clones circulating in Slovenia for 2010, 2014 and 2015.
The distribution of presumptive CA-MRSA clones circulating in Slovenia for 2010, 2014 and 2015.

Figure 3

The distribution and prevalence of ST398 clone and mecC MRSA in Slovenia for 2010, 2014 and 2015.
The distribution and prevalence of ST398 clone and mecC MRSA in Slovenia for 2010, 2014 and 2015.

Distribution of presumptive CA-MRSA isolates among clinical specimens.

Specimen Results

value is number (%)

 for MRSA patients from
2010 2014 2015
(n=16) (n=20) (n=25)
Skin and soft tissue 12 (75) 13 (65) 13 (52)
Aspirate tracheae 1 (6.3) 4 (20) 4 (16)
Knee joint puncture - 1 (5) 1 (4)
Urine 1 (6.3) 1 (5) 2 (8)
Nose swab - 1 (5) 1 (4)
Blood culture - - 1 (4)
Bone - - 1 (4)
Faeces - - 1 (4)
Nasopharynx - - 1 (4)
Ear swab 2 (12.4) - -

Virulence factors of Slovenian presumptive CA-MRSA isolates from 2010, 2014 and 2015.

2010* (n=92) 2014 (n=122) 2015 (n=182) p-value (Chi-square test)
Virulence factor
% (number) of presumptive CA-MRSA isolates Year 2014 vs. 2010 Year 2015 vs. 2010
sea 6.5 (6) 2.5 (3) 8.2 (15) 0.15 0.61
seb 2.2 (2) 1.6 (2) 3.3 (6) 0.77 0.60
sec 35.8 (33) 10.7 (13) 22.5 (41) < 0.0001 0.01
sed 15.2 (14) 14.7 (18) 9.3 (17) 0.92 0.15
see 0 0 0 - -
Locus egc 54.3 (50) 43.4 (53) 40.7 (74) 0.11 0.03
PVL 8.7 (8) 10.7 (13) 5.5 (10) 0.63 0.31
tst 8.7 (8) 1.6 (2) 12.6 (23) 0.02 0.33
eta 0 0.8 (1) 0.5 (1) 0.61 0.79
etb 0 0 0 - -
etd 0 0 1.6 (3) - 0.39

Most frequent spa types and sequence types of presumptive CA-MRSA isolates from year 2010, 2014 and 2015.

2010*
 2014
 2017
Rank spa type Frequency % (number) MLSTa spa type Frequency % (number) MLSTa spa type Frequency (number) % MLSTa
1 t015 21.8 (20) ST45 t011 17.1 (21) ST398b t011 17.0 (31) ST398b
2 t011 13.0 (12) ST398b t359 9.8 (12) ST97 t034 6.6 (12) ST398b
3 t728 6.5 (6) ST45 t002 8.1 (10) ST5 t127 5.5 (10) ST1
4 t091 6.5 (6) ST7 t127 6.5 (8) ST1 t728 5.5 (10) ST45
5 t008 5.4 (5) ST8 t034 4.9 (6) ST398b t002 4.9 (9) ST5
6 t002 4.3 (4) ST5 t003 4.9 (6) ST5 t015 4.4 (8) ST45
7 t005 4.3 (4) ST22 t015 4.1 (5) ST45 t359 3.8 (7) ST97
8 t026 4.3 (4) ST45 t050 3.3 (4) ST45 t1048 3.3 (6) ST130
9 t127 3.3 (3) ST1 t008 2.4 (3) ST8 t091 2.2 (4) ST7
10 t020 2.2 (2) ST22 t2164 2.4 (3) ST5 t223 2.2 (4) ST22
>10 t003, t006, 28.4 (26) ST1, ST5, t026, t032, 36.5 (45) ST5, ST7, t003, t005, 44.6 (81) ST1, ST5,
t034, t041, ST7, ST8, t091, t095, ST8, ST15, t008, t010, ST8, ST22,
t105, t108, ST22, ST30, t116, t189, ST22, ST30, t021, t022, t044, ST30, ST45,
t116, t174, ST45, ST72, t216, t223, ST45, ST59, t050, t051, t067, ST59, ST80,
t355, t595, ST88, ST130, t230, t267, ST88, ST97, t122, t131, t177, ST88, ST97,
t737, t791, ST152/377, t331, t355, ST152/377, t216, t304, t316, ST152/377,
t843, t846, ST225, t448, t622, ST130, ST188, t331, t334, t447, ST130,
t1079, t1094, ST228, ST398 t693, t728, ST398, ST627, t448, t583, t589, ST188,
t1111, t1179, t808, t843, ST1774, t595, t685, t786, ST247,
t1218, t1231, t1081, t1094, ST3138 t843, t976, t991, ST398,
t1509, t1911, t1192, t1340, t1344, t1451, t1510, ST913,
t2032, t3824, t1451, t1689, t1523, t1689, ST3138
t4365, t1842, t1943, t1943, t2032, t2135,
t13070 t4335, t5032, t2289, t2576, t2970,
t5500, t7268, t3002, t3213, t3256,
t14168, t3380, t3673, t3992,
t14540, t4272, t4335, t4960,
t14541, t5168, t5510, t9397,
t14542, t10765, t12135,
t14546** t15607**, t15608,
t15609**, t15610**,
t15628**, t15629**,
t15773**, t15823**

Frequencies of virulence associated genes and spa types in presumptive CA-MRSA isolates from 2010, 2014 and 2015.

2010*
 2014
 2017
Rank Number of isolates Frequency % spa type (number) Number of isolates Frequency % spa type (number) Number of isolates Frequency % spa type (number)
sea 6 6.5 t008 (4), t041 (1), t2032 (1) 3 2.5 t008 (2), t003 (1) 15 8.2 t002 (5), t021 (1), t122 (1), t127 (1), t304 (3), t976 (2), t4335 (1), t12135 (1)
seb 2 2.2 t002 (1), t026 (1) 2 1.6 t216 (1), t1340 (1) 6 3.3 t216 (3), t976 (2), t2289 (1)
sec 33 35.8 t002 (1), t015 (18), t026 (3), t116 (1), t728 (5), t737 (1), t791 (1), t1079 (1), t1231 (1), t13070 (1) 13 10.7 t015 (2), t026 (1), t050 (1), t095 (1), t116 (2), t230 (1), t331 (3), t622 (1), t14540 (1) 41 22.5 t002 (4), t011 (1), t015 (6), t050 (1), t223 (2), t331 (2), t359 (1), t448 (1), t583 (2), t589 (1), t728 (10), t786 (1), t1048 (2), t1510 (1), t1523 (1), t3213 (1), t4335 (1), t5168 (1), t15628 (1), t15773 (1)
sed 14 15.2 t002 (2), t003 (1), t008 (4), t015 (2), t020 (1), t846 (1), t1094 (1), t1179 (1), t2032 (1) 18 14.7 t002 (9), t003 (3), t015 (1), t026 (1), t1192 (1), t2164 (2), t14541 (1) 17 9.3 t002 (4), t003 (2), t008 (2), t010 (2), t011 (1), t050 (1), t067 (1), t359 (1), t447 (1), t2032 (1), t15607 (1)
see none 0 - none 0 - none 0 -
Locus egc 50 54.3 t002 (4), t003 (1), t005 (3), t006 (1), t015 (20), t020 (1), t026 (4), t041 (1), t105 (1), t116 (1), t728 (5), t737 (1), t791 (1), t1079 (1), t1094 (1), t1111 (1), t1231 (1), t3824 (1), t13070 (1) 53 43.4 t002 (10), t003 (6), t015 (5), t026 (2), t032 (1), t050 (4), t095 (1), t116 (2), t223 (2), t230 (1), t331 (3), t359 (2), t448 (1), t622 (1), t728 (1), t808 (1), t1081 (1), t1192 (2), t1340 (1), t1842 (1), t2164 (2), t5032 (1), t14540 (1), t14541 (1) 74 40.7 t002 (9), t003 (2), t005 (2), t010 (1), t011 (3), t015 (7), t021 (1), t022 (1), t050 (1), t067 (1), t091 (1), t122 (1), t127 (1), t216 (1), t223 (4), t331 (2), t359 (1), t447 (1), t583 (2), t589 (1), t685 (1), t728 (10), t1048 (1), t1510 (1), t1523 (1), t2135 (1), t2289 (1), t3002 (2), t3213 (1), t3673 (1), t4335 (1), t5168 (1), t5510 (1), t15607 (1), t15608 (1), t15609 (1), t15610 (1), t15628 (1), t15629 (1), t15773 (1), t15823 (1)
PVL 8 8.7 t002 (2), t005 (1), t008 (1), t091 (1), t355 (1), t791 (1), t4335 (1) 13 10.7 t002 (9), t050 (1), t127 (1), t2164 (1), t355 (1) 10 5.5 t002 (4), t010 (1), t044 (1), t067 (1), t127 (1), t131 (1), t595 (1)
tst 8 8.7 t026 (1), t105 (1), t728 (5), t1111 (1) 2 1.6 t015 (1), t728 (1) 23 12.6 t002 (4), t015 (1), t122 (1), t223 (3), t359 (1), t685 (1), t728 (10), t4335 (1), t15610 (1)
eta none - - 1 0.8 t015 (1) 1 0.5 t991 (1)
etb none - - none - - none - -
etd none - - none - - 3 1.6 t044 (1), t131 (1), t991 (1)
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