Dataset Information

Staphylococcus aureus injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

ABSTRACT:

Background

The ongoing injection drug use (IDU) crisis in the United States has been complicated by an emerging epidemic of Staphylococcus aureus IDU-associated bloodstream infections (IDU-BSI).

Methods

We performed a case-control study comparing S. aureus IDU-BSI and non-IDU BSI cases identified in a large US Midwestern academic medical center between Jan 1, 2016 and Dec 21, 2019. We obtained the whole-genome sequences of 154 S. aureus IDU-BSI and 91 S. aureus non-IDU BSI cases, which were matched with clinical data. We performed phylogenetic and comparative genomic analyses to investigate clonal expansion of lineages and molecular features characteristic of IDU-BSI isolates.

Results

Here we show that patients with IDU-BSI experience longer durations of bacteremia and have lower medical therapy completion rates. In phylogenetic analyses, 45/154 and 1/91 contemporaneous IDU-BSI and non-IDU BSI staphylococcal isolates, respectively, group into multiple, unique clonal clusters, revealing that pathogen community transmission distinctively spurs IDU-BSI. Lastly, multiple S. aureus lineages deficient in canonical virulence genes are overrepresented among IDU-BSI, which may contribute to the distinguishable clinical presentation of IDU-BSI cases.

Conclusions

We identify clonal expansion of multiple S. aureus lineages among IDU-BSI isolates, but not non-IDU BSI isolates, in a community with limited access to needle exchange facilities. In the setting of expanding numbers of staphylococcal IDU-BSI cases consideration should be given to treating IDU-associated invasive staphylococcal infections as a communicable disease.

SUBMITTER: Marks LR

PROVIDER: S-EPMC9053277 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

<i>Staphylococcus aureus</i> injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

Marks Laura R LR Calix Juan J JJ Wildenthal John A JA Wallace Meghan A MA Sawhney Sanjam S SS Ransom Eric M EM Durkin Michael J MJ Henderson Jeffrey P JP Burnham Carey-Ann D CD Dantas Gautam G

Communications medicine 20211130

<h4>Background</h4>The ongoing injection drug use (IDU) crisis in the United States has been complicated by an emerging epidemic of <i>Staphylococcus aureus</i> IDU-associated bloodstream infections (IDU-BSI).<h4>Methods</h4>We performed a case-control study comparing <i>S. aureus</i> IDU-BSI and non-IDU BSI cases identified in a large US Midwestern academic medical center between Jan 1, 2016 and Dec 21, 2019. We obtained the whole-genome sequences of 154 <i>S. aureus</i> IDU-BSI and 91 <i>S. au ...[more]

PMID: 35602233

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Project description:BackgroundBloodstream infections due to Staphylococcus aureus cause significant patient morbidity and mortality worldwide. Of major concern is the emergence and spread of methicillin-resistant S. aureus (MRSA) in bloodstream infections, which are associated with therapeutic failure and increased mortality.MethodsWe generated high quality draft genomes from 323 S. aureus blood culture isolates from patients diagnosed with bloodstream infection at the Dartmouth-Hitchcock Medical Center, New Hampshire, USA in 2010-2018.ResultsIn silico detection of antimicrobial resistance genes revealed that 133/323 isolates (41.18%) carry horizontally acquired genes conferring resistance to at least three antimicrobial classes, with resistance determinants for aminoglycosides, beta-lactams and macrolides being the most prevalent. The most common resistance genes were blaZ and mecA, which were found in 262/323 (81.11%) and 104/323 (32.20%) isolates, respectively. Majority of the MRSA (102/105 isolates or 97.14%) identified using in vitro screening were related to two clonal complexes (CC) 5 and 8. The two CCs emerged in the New Hampshire population at separate times. We estimated that the time to the most recent common ancestor of CC5 was 1973 (95% highest posterior density (HPD) intervals: 1966-1979) and 1946 for CC8 (95% HPD intervals: 1924-1959). The effective population size of CC8 increased until the late 1960s when it started to level off until late 2000s. The levelling off of CC8 in 1968 coincided with the acquisition of SCCmec Type IV in majority of the strains. The plateau in CC8 also coincided with the acceleration in the population growth of CC5 carrying SCCmec Type II in the early 1970s, which eventually leveled off in the early 1990s. Lastly, we found evidence for frequent recombination in the two clones during their recent clonal expansion, which has likely contributed to their success in the population.ConclusionsWe conclude that the S. aureus population was shaped mainly by the clonal expansion, recombination and co-dominance of two major MRSA clones in the last five decades in New Hampshire, USA. These results have important implications on the development of effective and robust strategies for intervention, control and treatment of life-threatening bloodstream infections.

Dataset Information

Staphylococcus aureus injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

Background

Methods

Results

Conclusions

Publications

<i>Staphylococcus aureus</i> injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

Staphylococcus aureus injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

Background

Methods

Results

Conclusions

Publications

&lt;i&gt;Staphylococcus aureus&lt;/i&gt; injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

<i>Staphylococcus aureus</i> injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages.