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

Dermota, Urška; Košnik, Irena Grmek; Janežič, Sandra; Rupnik, Maja

doi:10.2478/sjph-2020-0030

Figures & Tables

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

The distribution of presumptive CA-MRSA clones circulating 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
Specimen	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)	MLST^a	spa type	Frequency % (number)	MLST^a	spa type	Frequency (number)	% MLST^a
1	t015	21.8 (20)	ST45	t011	17.1 (21)	ST398^b	t011	17.0 (31)	ST398^b

2	t011	13.0 (12)	ST398^b	t359	9.8 (12)	ST97	t034	6.6 (12)	ST398^b

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)	ST398^b	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)

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

Figures & Tables

Figure 1

Figure 2

Figure 3

Distribution of presumptive CA-MRSA isolates among clinical specimens_

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

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

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

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