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Title: Whole genome sequencing and molecular epidemiology of paediatric Staphylococcus aureus bacteraemia.
Authors: Campbell AJ
Mowlaboccus S
Coombs GW
Daley DA
Al Yazidi LS
Phuong LK
Leung C
Best EJ
Webb RH
Voss L
Athan E
Britton PN
Bryant PA
Butters CT
Carapetis JR
Ching NS
Francis JR
Hung TY
Nourse C
Ojaimi S
Tai A
Vasilunas N
McMullan B
Bowen AC
Blyth CC
Citation: Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.
J Glob Antimicrob Resist. 2022 Jun;29:197-206. doi: 10.1016/j.jgar.2022.03.012. Epub 2022 Mar 25.
Abstract: OBJECTIVES: The role Staphylococcus aureus antimicrobial resistance genes and toxins play in disease severity, management and outcome in childhood is an emerging field requiring further exploration. METHODS: A prospective multisite study of Australian and New Zealand children hospitalised with S. aureus bacteraemia (SAB) occurred over 24 months (2017-2018). Whole genome sequencing (WGS) data were paired with clinical information from the ISAIAH cohort. RESULTS: 353 SAB isolates were sequenced; 85% methicillin-susceptible S. aureus ([MSSA], 301/353) and 15% methicillin-resistant S. aureus ([MRSA], 52/353). There were 92 sequence types (STs), most commonly ST5 (18%) and ST30 (8%), grouped into 23 clonal complexes (CCs), most frequently CC5 (21%) and CC30 (12%). MSSA comprised the majority of healthcare-associated SAB (87%, 109/125), with principal clones CC15 (48%, 11/21) and CC8 (33%, 7/21). Panton-Valentine leukocidin (PVL)-positive SAB occurred in 22% (76/353); predominantly MSSA (59%, 45/76), community-onset (92%, 70/76) infections. For community-onset SAB, the only microbiological independent predictor of poor outcomes was PVL positivity (aOR 2.6 [CI 1.0-6.2]). CONCLUSION: From this WGS paediatric SAB data, we demonstrate the previously under-recognized role MSSA has in harbouring genetic virulence and causing healthcare-associated infections. PVL positivity was the only molecular independent predictor of poor outcomes in children. These findings underscore the need for further research to define the potential implications PVL-producing strains may have on approaches to S. aureus clinical management.
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Journal title: Journal of global antimicrobial resistance
Volume: 29
Pages: 197-206
Publication Date: 2022-06-01
Type: Journal Article
DOI: 10.1016/j.jgar.2022.03.012
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