Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system

Background: In the past decade, several countries have seen gradual replacement of endemic multi-resistant healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) with clones that are more susceptible to antibiotic treatment. One example is Singapore, where MRSA ST239, the dominant...

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Main Authors: Hsu, L., Harris, S., Chlebowicz, M., Lindsay, J., Koh, T., Krishnan, P., Tan, T., Hon, P., Grubb, Warren, Bentley, S., Parkhill, J., Peacock, S., Holden, M.
Format: Journal Article
Published: BioMed Central Ltd. 2015
Online Access:http://hdl.handle.net/20.500.11937/20175
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author Hsu, L.
Harris, S.
Chlebowicz, M.
Lindsay, J.
Koh, T.
Krishnan, P.
Tan, T.
Hon, P.
Grubb, Warren
Bentley, S.
Parkhill, J.
Peacock, S.
Holden, M.
author_facet Hsu, L.
Harris, S.
Chlebowicz, M.
Lindsay, J.
Koh, T.
Krishnan, P.
Tan, T.
Hon, P.
Grubb, Warren
Bentley, S.
Parkhill, J.
Peacock, S.
Holden, M.
author_sort Hsu, L.
building Curtin Institutional Repository
collection Online Access
description Background: In the past decade, several countries have seen gradual replacement of endemic multi-resistant healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) with clones that are more susceptible to antibiotic treatment. One example is Singapore, where MRSA ST239, the dominant clone since molecular profiling of MRSA began in the mid-1980s, has been replaced by ST22 isolates belonging to EMRSA-15, a recently emerged pandemic lineage originating from Europe. Results: We investigated the population structure of MRSA in Singaporean hospitals spanning three decades, using whole genome sequencing. Applying Bayesian phylogenetic methods we report that prior to the introduction of ST22, the ST239 MRSA population in Singapore originated from multiple introductions from the surrounding region; it was frequently transferred within the healthcare system resulting in a heterogeneous hospital population. Following the introduction of ST22 around the beginning of the millennium, this clone spread rapidly through Singaporean hospitals, supplanting the endemic ST239 population. Coalescent analysis revealed that although the genetic diversity of ST239 initially decreased as ST22 became more dominant, from 2007 onwards the genetic diversity of ST239 began to increase once more, which was not associated with the emergence of a sub-clone of ST239. Comparative genomic analysis of the accessory genome of the extant ST239 population identified that the Arginine Catabolic Mobile Element arose multiple times, thereby introducing genes associated with enhanced skin colonization into this population. Conclusions: Our results clearly demonstrate that, alongside clinical practice and antibiotic usage, competition between clones also has an important role in driving the evolution of nosocomial pathogen populations.
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spelling curtin-20.500.11937-201752017-09-13T13:48:57Z Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system Hsu, L. Harris, S. Chlebowicz, M. Lindsay, J. Koh, T. Krishnan, P. Tan, T. Hon, P. Grubb, Warren Bentley, S. Parkhill, J. Peacock, S. Holden, M. Background: In the past decade, several countries have seen gradual replacement of endemic multi-resistant healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) with clones that are more susceptible to antibiotic treatment. One example is Singapore, where MRSA ST239, the dominant clone since molecular profiling of MRSA began in the mid-1980s, has been replaced by ST22 isolates belonging to EMRSA-15, a recently emerged pandemic lineage originating from Europe. Results: We investigated the population structure of MRSA in Singaporean hospitals spanning three decades, using whole genome sequencing. Applying Bayesian phylogenetic methods we report that prior to the introduction of ST22, the ST239 MRSA population in Singapore originated from multiple introductions from the surrounding region; it was frequently transferred within the healthcare system resulting in a heterogeneous hospital population. Following the introduction of ST22 around the beginning of the millennium, this clone spread rapidly through Singaporean hospitals, supplanting the endemic ST239 population. Coalescent analysis revealed that although the genetic diversity of ST239 initially decreased as ST22 became more dominant, from 2007 onwards the genetic diversity of ST239 began to increase once more, which was not associated with the emergence of a sub-clone of ST239. Comparative genomic analysis of the accessory genome of the extant ST239 population identified that the Arginine Catabolic Mobile Element arose multiple times, thereby introducing genes associated with enhanced skin colonization into this population. Conclusions: Our results clearly demonstrate that, alongside clinical practice and antibiotic usage, competition between clones also has an important role in driving the evolution of nosocomial pathogen populations. 2015 Journal Article http://hdl.handle.net/20.500.11937/20175 10.1186/s13059-015-0643-z BioMed Central Ltd. fulltext
spellingShingle Hsu, L.
Harris, S.
Chlebowicz, M.
Lindsay, J.
Koh, T.
Krishnan, P.
Tan, T.
Hon, P.
Grubb, Warren
Bentley, S.
Parkhill, J.
Peacock, S.
Holden, M.
Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title_full Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title_fullStr Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title_full_unstemmed Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title_short Evolutionary dynamics of methicillin-resistant Staphylococcus aureus within a healthcare system
title_sort evolutionary dynamics of methicillin-resistant staphylococcus aureus within a healthcare system
url http://hdl.handle.net/20.500.11937/20175