Scripties UMCG - Rijksuniversiteit Groningen
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Comparative molecular characterization and analysis of the Staphylococcus aureus population structure from clinical samples in acute care hospitals in the Dutch-German border region – Ems-Dollart Regio (EDR)

(2018) Himmels, D. (Dunja)

Staphylococcus aureus is a globally disseminated gram-positive bacterium. It causes hospital- and community-acquired infections, exhibits an increasing threat to patients and is able to infect any organ system causing septicemia, pneumonia, osteomyelitis or endocarditis(1, 2). In general, S. aureus is susceptible to methicillin (MSSA) but some clones acquired genetically determined methicillin-resistance (MRSA) associated with additional penicillin-binding-protein (PbP) 2A located on mobile genetic element. For infection prevention and control it is necessary to understand the transmission dynamics of MRSA. Especially in the border regions between two countries where patient movement is frequent, the MRSA transmission might be supported. This study will investigate the genetic background of MRSA isolates in Dutch and German strains. A total number of 85 (German n=73, Dutch n=12) MRSA isolates, each isolated from an individual patient, was collected from two hospitals between July 2014 and November 2016. The study-hospitals comprise the Klinikum Oldenburg in Germany and the University Medical Center Groningen, UMCG in the Netherlands. All isolates underwent genetic typing with whole genome sequencing (WGS). Based on the WGS data typing information was extracted such as the MLST CC, MLST ST, SCCmec type, spa type and the presence of specific resistance or virulence genes. The isolates that were sequenced belonged to seven MLST clonal complexes represented by ten MLST sequence types. Overall MLST CC 22 was the most common sequence type (n=65) that included exclusively isolates detected in Oldenburg. The most frequently found isolate in the UMCG belonged to MLST CC 5 (n=5) followed by MLST CC 8 (n=4). The detection of further genes showed that there is a clear split between the German and the Dutch isolates. Even though when the cross-border treatment and the patient movement between hospitals of Oldenburg and Groningen is high, the transmission of specific MRSA subtypes was not detected. This is most likely the result of the search and destroy policy in the Netherlands, so that the spread of a German strain is stopped by the Dutch hygienic regime.

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