230. Molecular Typing of Streptococcus pyogenes Isolates Collected at Mongolian Hospital (Ulaanbaatar, Mongolia).
mortality; epidemiology; antibiotic resistance; medical; surveillance; genes; bacterial; morbidity; infection; molecular; mongolia; antimicrobial susceptibility; china; communicable diseases; DRUG resistance in bacteria; LOW-income countries; disclosure; polymerase chain reaction; CENTERS for Disease Control & Prevention (U.S.); clone cells; communicable diseases; disease outbreaks; ichthyosis; low income; MOLECULAR epidemiology; mongolia; multi-antibiotic resistance; sequence tagged sites; sodium thiosulfate; streptococcus pyogenes; streptococcus pyogenes; TOXIC shock syndrome; ULAANBAATAR (Mongolia); vaccine development; x-linked
Background Streptococcus pyogenes is a significant cause of morbidity and mortality worldwide causing an estimated 1.8 million cases and 517,000 deaths each year. S. pyogenes infections disproportionately affect low-income countries where routine surveillance is not available. The objective of this study was to investigate the molecular epidemiology and antibiotic resistance of clinically relevant S. pyogenes isolates in Ulaanbaatar, Mongolia, to better understand the burden in this under-served population. Methods Clinical S. pyogenes isolates (n = 41) collected at the Bacteriological Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia, were cultured and characterized using PCR techniques. The emm gene was sequenced and emm type was assigned as per Centers for Disease Control and Prevention (CDC) methods and guideline. Multi-locus sequence typing (MLST) was carried out on selected isolates (n = 15). Antibiotic susceptibility testing (AST) was done via the Vitek-2 system as per manufacturer's instructions. Results We observed 18 distinct emm types among the 41 S. pyogenes isolates. stG6792.0 was the most common emm type, accounting for more than one-third of the isolates (15/41) followed by emm 2.0 (ST55) (5/41) and emm 82.0 (ST314) (2/41). A total of seven sequence types (STs) were detected among 15 tested isolates. The most common ST type was ST55 accounting for one-third of the isolates (5/15). Most of the isolates were susceptible to all tested drugs. Conclusion The findings of this study provided some insights regarding the molecular characteristics of S. pyogenes in Mongolia that will be crucial for future surveillance studies. Five isolates of this study had similar emm types (emm74.0, emm66.0, stG480.0, emm83.1, emm89.0) compared with a previous surveillance study. emm89.0 (ST101) was a major epidemiological isolate in the United States between 2000 and 2004. emm89.0 was also implicated with a recent single-clone outbreak in China. This information suggests the possibility of a shifting epidemiological trend of S. pyogenes on the global stage. The information about antibiotic susceptibility patterns and molecular types can help to devise better treatment strategies for S. pyogenes infections, and potentially inform vaccine development. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]
Thapaliya Dipendra; Mackey Samantha; Kadariya Jhalka; Davaadash Bulgan; Smith Tara
Open Forum Infectious Diseases
2019
2019-10-02
Journal Article
<a href="http://doi.org/10.1093/ofid/ofz360.305" target="_blank" rel="noreferrer noopener">10.1093/ofid/ofz360.305</a>
233. The Epidemiology, Genomics, and Evolution of Staphylococcus aureus in Northeast Ohio.
mortality; epidemiology; prevention; Community; OHIO; inpatients; morbidity; infection; OHIO; genomics; institutional review board; risk reduction; METHICILLIN-resistant staphylococcus aureus; genomics; epidemiology; staphylococcus aureus; AKRON (Ohio); CLEVELAND Clinic Foundation; databases; disclosure; FOOD poisoning; HUMAN ecology; meca gene; methicillin; METHICILLIN-resistant staphylococcus aureus; MICROCOCCACEAE; polymerase chain reaction; staphylococcal protein a; staphylococcus; staphylococcus aureus
Background Infections due to S. aureus result in significant morbidity, mortality, and healthcare expense. We sought to identify the strains of S. aureus causing infections in hospitalized patients in Northeast Ohio and determine whether they are reflective of the S. aureus strains present in the surrounding environment. Methods The study was approved by the Institutional Review Board at Cleveland Clinic Akron General. Clinical S. aureus isolates (n = 300) were cultured and PCR was used to amplify the staphylococcus protein A (spa), Panton–Valentine Leukocidin (PVL), and mecA genes. The clinical spa types were compared with ones from our data base of S. aureus strains previously collected and sequenced from the community and environment in Northeast Ohio. Results A total of 51 spa types were detected from 129 S. aureus clinical isolates (discriminatory index, 0.876; 95% confidence interval [CI], 0.827–0.925; Table 1). The most common spa types were t008 (42/129, 32.6%), t002 (16/129, 12.4%), and t334 (6/129, 4.7%). In comparison, the most frequently detected spa types from the environmental samples were t189 (40/257, 15.6%), t002 (16/257, 6.2%), and t008 (11/257, 4.3%). Among the S. aureus isolates (n = 146), 45 were PVL-positive (30.8%) and 94 (66.7%) carried mecA. Of the 42 t008 (ST8/USA300; a common community-associated strain) isolates, 35 (83.3%) were methicillin-resistant S. aureus (MRSA) (based on the presence of the mecA gene) and 25 (59.5%) were PVL-positive. Thirteen of the sixteen (81.2%) t002 (ST5/USA100; a common hospital-associated strain) were MRSA and only one (6.2%) was PVL-positive. Conclusion There is considerable overlap of S. aureus strains present in clinical samples with those found in the environment. This finding should draw attention to the need for more effective prevention strategies to reduce the risk of transmission of S. aureus, including MRSA, in the environment to humans. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]
Watkins Richard R; Thapaliya Dipendra; Savri Rami; Smith Tara
Open Forum Infectious Diseases
2019
2019-10-02
Journal Article
<a href="http://doi.org/10.1093/ofid/ofz360.308" target="_blank" rel="noreferrer noopener">10.1093/ofid/ofz360.308</a>