TY - JOUR
T1 - Whole genome sequencing and molecular epidemiology of paediatric Staphylococcus aureus bacteraemia
AU - Campbell, Anita J.
AU - Mowlaboccus, Shakeel
AU - Coombs, Geoffrey W.
AU - Daley, Denise A.
AU - Al Yazidi, Laila S.
AU - Phuong, Linny K.
AU - Leung, Clare
AU - Best, Emma J.
AU - Webb, Rachel H.
AU - Voss, Lesley
AU - Athan, Eugene
AU - Britton, Philip N.
AU - Bryant, Penelope A.
AU - Butters, Coen T.
AU - Carapetis, Jonathan R.
AU - Ching, Natasha S.
AU - Francis, Joshua
AU - Hung, Te Yu
AU - Nourse, Clare
AU - Ojaimi, Samar
AU - Tai, Alex
AU - Vasilunas, Nan
AU - McMullan, Brendan
AU - Bowen, Asha C.
AU - Blyth, Christopher C.
AU - Australian and New Zealand Pediatric Infectious Diseases (ANZPID) clinical research network (CRN) of the Australasian Society of Infectious Diseases (ASID) and the Australian Group on Antimicrobial Resistance (AGAR)
N1 - Funding Information:
This work was supported by the Australian Society of Antimicrobials award as well as National Health and Medical Research Council PhD Scholarship to A.J.C. (grant GNT1133670), a National Health and Medical Research Council fellowship to A.C.B. (grant GNT1175509), and a National Health and Medical Research Council fellowship to C.C.B. (grant GNT1088735).
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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.
KW - Bacteraemia
KW - Molecular
KW - Outcomes
KW - Paediatrics
KW - Staphylococcus aureus
KW - Whole genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85130869503&partnerID=8YFLogxK
U2 - 10.1016/j.jgar.2022.03.012
DO - 10.1016/j.jgar.2022.03.012
M3 - Article
C2 - 35342022
AN - SCOPUS:85130869503
SN - 2213-7165
VL - 29
SP - 197
EP - 206
JO - Journal of Global Antimicrobial Resistance
JF - Journal of Global Antimicrobial Resistance
ER -
