MRSA Strains with Distinct Accessory Genes Predominate at Different Ages in Cystic Fibrosis

Harry S Porterfield; Lucas J Maakestad; Mason M LaMarche; Andrew L Thurman; Zoe E Kienenberger; Nicholas J Pitcher; Alexis R Hansen; Christian F Zirbes; Linda Boyken; Bethany L Muyskens; Alejandro A Pezzulo; Sachinkumar B Singh; Erik Twait; Bradley Ford; Daniel J Diekema; Valérie Reeb; Anthony J Fischer

doi:10.1002/ppul.25559

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MRSA Strains with Distinct Accessory Genes Predominate at Different Ages in Cystic Fibrosis

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MRSA Strains with Distinct Accessory Genes Predominate at Different Ages in Cystic Fibrosis

Harry S Porterfield, Lucas J Maakestad, Mason M LaMarche, Andrew L Thurman, Zoe E Kienenberger, Nicholas J Pitcher, Alexis R Hansen, Christian F Zirbes, Linda Boyken, Bethany L Muyskens, …

Pediatric pulmonology, Vol.56(9), pp.2868-2878

07/05/2021

DOI: 10.1002/ppul.25559

PMCID: PMC8395597

PMID: 34219414

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Abstract

Rationale Methicillin resistant Staphylococcus aureus (MRSA) is prevalent and consequential in cystic fibrosis (CF). Whole genome sequencing (WGS) could reveal genomic differences in MRSA associated with poorer outcomes or detect MRSA transmission. Objectives To identify MRSA genes associated with low lung function and potential MRSA transmission in CF. Methods We collected 97 MRSA isolates from 74 individuals with CF from 2017 and performed short-read WGS. We determined sequence type (ST) and the phylogenetic relationship between isolates. We aligned accessory genes from 25 reference genomes to genome assemblies, classified isolates by accessory gene content, and correlated the accessory genome to clinical outcomes. Results The most prevalent ST were ST5 (N = 55), ST8 (N = 15), and ST105 (N = 14). Closely related MRSA strains were shared by family members with CF, but rarely between unrelated individuals. Three clusters of MRSA were identified by accessory genome content. Cluster A, including ST5 and ST105, was highly prevalent at all ages. Cluster B, including ST8, was more limited to younger patients. Cluster C included 6 distantly related strains. Patients 20 years old and younger infected with Cluster A had lower forced expiratory volume in the first second (FEV1) and higher sputum biomass compared to similar-aged patients with Cluster B. Conclusions In this CF cohort, we identified MRSA subtypes that predominate at different ages and differ by accessory gene content. The most prevalent cluster of MRSA, including ST5 and ST105, was associated with lower FEV1. ST8 MRSA was more common in younger patients and thus has the potential to rise in prevalence as these patients age.

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Title: Subtitle: MRSA Strains with Distinct Accessory Genes Predominate at Different Ages in Cystic Fibrosis
Creators: Harry S Porterfield - Pathology, University of Iowa Carver College of Medicine Iowa City IA 52242, Department of Laboratory Medicine NIH Clinical Center Bethesda MD 20892
Lucas J Maakestad - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Mason M LaMarche - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Andrew L Thurman - Internal Medicine University of Iowa Carver College of Medicine Iowa City IA 52242
Zoe E Kienenberger - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Nicholas J Pitcher - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Alexis R Hansen - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Christian F Zirbes - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Linda Boyken - Pathology, University of Iowa Carver College of Medicine Iowa City IA 52242
Bethany L Muyskens - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Alejandro A Pezzulo - Internal Medicine University of Iowa Carver College of Medicine Iowa City IA 52242
Sachinkumar B Singh - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Erik Twait - State Hygienic Laboratory at the University of Iowa
Bradley Ford - Pathology, University of Iowa Carver College of Medicine Iowa City IA 52242
Daniel J Diekema - Internal Medicine University of Iowa Carver College of Medicine Iowa City IA 52242
Valérie Reeb - State Hygienic Laboratory at the University of Iowa
Anthony J Fischer - Pediatrics, University of Iowa Carver College of Medicine Iowa City IA 52242
Resource Type: Journal article
Publication Details: Pediatric pulmonology, Vol.56(9), pp.2868-2878
DOI: 10.1002/ppul.25559
PMID: 34219414
PMCID: PMC8395597
NLM abbreviation: Pediatr Pulmonol
ISSN: 8755-6863
eISSN: 1099-0496
Grant note: DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: UL1TR002537; DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention, award: Advanced Molecular Detection, Epidemiology and Lab; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: K08 HL136927; DOI: 10.13039/100000897, name: Cystic Fibrosis Foundation, award: FISCHE20A0‐KB, Research and Development Program: STOLTZ19R0
Language: English
Date published: 07/05/2021
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Pulmonary Medicine; Infectious Diseases; Stead Family Department of Pediatrics; Hygienic Laboratory - Bdc; Pathology; Iowa Neuroscience Institute; Internal Medicine
Record Identifier: 9984103168902771

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