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Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study.
Lancet Infect Dis. 2011 Aug; 11(8):595-603.LI

Abstract

BACKGROUND

Animals can act as a reservoir and source for the emergence of novel meticillin-resistant Staphylococcus aureus (MRSA) clones in human beings. Here, we report the discovery of a strain of S aureus (LGA251) isolated from bulk milk that was phenotypically resistant to meticillin but tested negative for the mecA gene and a preliminary investigation of the extent to which such strains are present in bovine and human populations.

METHODS

Isolates of bovine MRSA were obtained from the Veterinary Laboratories Agency in the UK, and isolates of human MRSA were obtained from diagnostic or reference laboratories (two in the UK and one in Denmark). From these collections, we searched for mecA PCR-negative bovine and human S aureus isolates showing phenotypic meticillin resistance. We used whole-genome sequencing to establish the genetic basis for the observed antibiotic resistance.

FINDINGS

A divergent mecA homologue (mecA(LGA251)) was discovered in the LGA251 genome located in a novel staphylococcal cassette chromosome mec element, designated type-XI SCCmec. The mecA(LGA251) was 70% identical to S aureus mecA homologues and was initially detected in 15 S aureus isolates from dairy cattle in England. These isolates were from three different multilocus sequence type lineages (CC130, CC705, and ST425); spa type t843 (associated with CC130) was identified in 60% of bovine isolates. When human mecA-negative MRSA isolates were tested, the mecA(LGA251) homologue was identified in 12 of 16 isolates from Scotland, 15 of 26 from England, and 24 of 32 from Denmark. As in cows, t843 was the most common spa type detected in human beings.

INTERPRETATION

Although routine culture and antimicrobial susceptibility testing will identify S aureus isolates with this novel mecA homologue as meticillin resistant, present confirmatory methods will not identify them as MRSA. New diagnostic guidelines for the detection of MRSA should consider the inclusion of tests for mecA(LGA251).

FUNDING

Department for Environment, Food and Rural Affairs, Higher Education Funding Council for England, Isaac Newton Trust (University of Cambridge), and the Wellcome Trust.

Authors+Show Affiliations

Department of Veterinary Medicine, University of Cambridge, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21641281

Citation

García-Álvarez, Laura, et al. "Meticillin-resistant Staphylococcus Aureus With a Novel mecA Homologue in Human and Bovine Populations in the UK and Denmark: a Descriptive Study." The Lancet. Infectious Diseases, vol. 11, no. 8, 2011, pp. 595-603.
García-Álvarez L, Holden MT, Lindsay H, et al. Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. Lancet Infect Dis. 2011;11(8):595-603.
García-Álvarez, L., Holden, M. T., Lindsay, H., Webb, C. R., Brown, D. F., Curran, M. D., Walpole, E., Brooks, K., Pickard, D. J., Teale, C., Parkhill, J., Bentley, S. D., Edwards, G. F., Girvan, E. K., Kearns, A. M., Pichon, B., Hill, R. L., Larsen, A. R., Skov, R. L., ... Holmes, M. A. (2011). Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. The Lancet. Infectious Diseases, 11(8), 595-603. https://doi.org/10.1016/S1473-3099(11)70126-8
García-Álvarez L, et al. Meticillin-resistant Staphylococcus Aureus With a Novel mecA Homologue in Human and Bovine Populations in the UK and Denmark: a Descriptive Study. Lancet Infect Dis. 2011;11(8):595-603. PubMed PMID: 21641281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meticillin-resistant Staphylococcus aureus with a novel mecA homologue in human and bovine populations in the UK and Denmark: a descriptive study. AU - García-Álvarez,Laura, AU - Holden,Matthew T G, AU - Lindsay,Heather, AU - Webb,Cerian R, AU - Brown,Derek F J, AU - Curran,Martin D, AU - Walpole,Enid, AU - Brooks,Karen, AU - Pickard,Derek J, AU - Teale,Christopher, AU - Parkhill,Julian, AU - Bentley,Stephen D, AU - Edwards,Giles F, AU - Girvan,E Kirsty, AU - Kearns,Angela M, AU - Pichon,Bruno, AU - Hill,Robert L R, AU - Larsen,Anders Rhod, AU - Skov,Robert L, AU - Peacock,Sharon J, AU - Maskell,Duncan J, AU - Holmes,Mark A, PY - 2011/6/7/entrez PY - 2011/6/7/pubmed PY - 2011/10/18/medline SP - 595 EP - 603 JF - The Lancet. Infectious diseases JO - Lancet Infect Dis VL - 11 IS - 8 N2 - BACKGROUND: Animals can act as a reservoir and source for the emergence of novel meticillin-resistant Staphylococcus aureus (MRSA) clones in human beings. Here, we report the discovery of a strain of S aureus (LGA251) isolated from bulk milk that was phenotypically resistant to meticillin but tested negative for the mecA gene and a preliminary investigation of the extent to which such strains are present in bovine and human populations. METHODS: Isolates of bovine MRSA were obtained from the Veterinary Laboratories Agency in the UK, and isolates of human MRSA were obtained from diagnostic or reference laboratories (two in the UK and one in Denmark). From these collections, we searched for mecA PCR-negative bovine and human S aureus isolates showing phenotypic meticillin resistance. We used whole-genome sequencing to establish the genetic basis for the observed antibiotic resistance. FINDINGS: A divergent mecA homologue (mecA(LGA251)) was discovered in the LGA251 genome located in a novel staphylococcal cassette chromosome mec element, designated type-XI SCCmec. The mecA(LGA251) was 70% identical to S aureus mecA homologues and was initially detected in 15 S aureus isolates from dairy cattle in England. These isolates were from three different multilocus sequence type lineages (CC130, CC705, and ST425); spa type t843 (associated with CC130) was identified in 60% of bovine isolates. When human mecA-negative MRSA isolates were tested, the mecA(LGA251) homologue was identified in 12 of 16 isolates from Scotland, 15 of 26 from England, and 24 of 32 from Denmark. As in cows, t843 was the most common spa type detected in human beings. INTERPRETATION: Although routine culture and antimicrobial susceptibility testing will identify S aureus isolates with this novel mecA homologue as meticillin resistant, present confirmatory methods will not identify them as MRSA. New diagnostic guidelines for the detection of MRSA should consider the inclusion of tests for mecA(LGA251). FUNDING: Department for Environment, Food and Rural Affairs, Higher Education Funding Council for England, Isaac Newton Trust (University of Cambridge), and the Wellcome Trust. SN - 1474-4457 UR - https://www.unboundmedicine.com/medline/citation/21641281/Meticillin_resistant_Staphylococcus_aureus_with_a_novel_mecA_homologue_in_human_and_bovine_populations_in_the_UK_and_Denmark:_a_descriptive_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1473-3099(11)70126-8 DB - PRIME DP - Unbound Medicine ER -