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

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)	-	-

a value is number (%)

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

Table 2

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

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

[i] Legend: *Previously published (9); **New spa type; ^aAssociated multilocus sequence types published on http://spaserver.ridom.de;^bPreviously published (15). Underlined spa type multilocus sequence types are those determined in this study.

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

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

Table 3

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

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)

[i] Legend: *Data already shown by Dermota et al. 2015; sea staphylococcal enterotoxin gene type A, seb staphylococcal enterotoxin gene type B, sec staphylococcal enterotoxin gene type C, sed staphylococcal enterotoxin gene type D, see staphylococcal enterotoxin gene type E, locus egc locus enterotoxin gene cluster, PVL Panton-Valentine leukocidin, tst toxic shock syndrome toxin gene, eta exfoliative toxin type A, etb exfoliative toxin type B, etd exfoliative toxin type D

Table 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)
	% (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

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DOI: https://doi.org/10.2478/sjph-2020-0030 | Journal eISSN: 1854-2476 | Journal ISSN: 0351-0026

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Language: English, Slovenian

Page range: 236 - 244

Submitted on: Jan 28, 2020

Accepted on: Sep 16, 2020

Published on: Oct 18, 2020

Published by: National Institute of Public Health, Slovenia

In partnership with: Paradigm Publishing Services

Keywords:

Slovenia,

CA-MRSA,

LA-MRSA,

mecC,

Related subjects:

Hygiene and environmental medicine

© 2020 Urška Dermota, Irena Grmek Košnik, Sandra Janežič, Maja Rupnik, published by National Institute of Public Health, Slovenia
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 59 (2020): Issue 4 (December 2020)

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

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Table 4

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