Characterisation of clinical Staphylococcus aureus isolates harbouring mecA or Panton-Valentine leukocidin genes from four tertiary care hospitals in Indonesia

Dewi Santosaningsih, Sanarto Santoso, Nyoman S. Budayanti, Ketut Suata, Endang S. Lestari, Hendro Wahjono, Aziz Djamal, Kuntaman Kuntaman, Alex van Belkum, Mitchell Laurens, Susan V. Snijders, Diana Willemse-Erix, Wil H. Goessens, Henri A. Verbrugh, Juliëtte A. Severin

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Objectives: To determine the prevalence, antimicrobial susceptibility profiles and clonal distribution of either methicillin-resistant Staphylococcus aureus (MRSA) or Panton-Valentine leukocidin (PVL)-positive S. aureus obtained from clinical cultures in Indonesian hospitals. Methods: S. aureus isolates from clinical cultures of patients in four tertiary care hospitals in Denpasar, Malang, Padang and Semarang were included. We assessed the antimicrobial susceptibility profiles using the Vitek2® system, determined the presence of the mecA gene and genes encoding PVL using PCR and analysed the clonal relatedness with Raman spectroscopy. SCCmec typing was performed for all MRSA isolates. Multilocus sequence typing (MLST) was performed for a subset of isolates. Results: In total, 259 S. aureus strains were collected. Of these, 17/259 (6.6%) and 48/259 (18.5%) were MRSA and PVL-positive methicillin-susceptible S. aureus (MSSA), respectively. The prevalence of MRSA and PVL-positive MSSA ranged between 2.5-8.9% and 9.5-29.1%, respectively and depended on geographic origin. PVL-positive MRSA were not detected. Raman spectroscopy of the strains revealed multiple Raman types with two predominant clusters. We also showed possible transmission of a ST239-MRSA-SCCmec type III strain and a ST121 PVL-positive MSSA in one of the hospitals. Conclusions: We showed that MRSA and PVL-positive MSSA are of clinical importance in Indonesian hospitals. A national surveillance system should be set-up to further monitor this. To reduce the prevalence of MRSA in Indonesian hospitals, a bundle of intervention measures is highly recommended.

Original languageEnglish
Pages (from-to)610-618
Number of pages9
JournalTropical Medicine and International Health
Volume21
Issue number5
DOIs
Publication statusPublished - 1 May 2016

Keywords

  • Asia
  • Indonesia
  • Methicillin-resistant S. aureus
  • Panton-valentine leukocidin
  • Staphylococcus aureus

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