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An outbreak in intravenous drug users due to USA300 Latin-American variant community-acquired methicillin-resistant Staphylococcus aureus in France as early as 2007

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Abstract

Intravenous drug users are at increased risk of Staphylococcus aureus infections. Most cases are related to clones prevalent in the community. We report an outbreak of community-acquired methicillin-resistant Staphylococcus aureus infections that occurred from 2007 to 2009 in intravenous drug users and their close contacts in Northwestern France. Clinical and molecular investigations suggested that the clones were more similar than those usually isolated in the American continent although none of the patients traveled abroad or had contact with individuals who had traveled to the Americas. Then, a retrospective whole genome sequencing and phylogenetic analyses demonstrated that the strains isolated from the first case belong to the USA300 Latin-American variant clone, based on the absence of arginine catabolic mobile element (ACME), and the presence of copper and mercury resistance mobile element (COMER), a distinctive feature of the South American variant. Our study shows genetic evidence for introduction of this clone as early as 2007 in France. This report also illustrates the importance of genome sequencing to finely characterize and monitor the emergence of unexpected S. aureus clones among high-risk populations, especially when living in promiscuity.

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Acknowledgements

We thank the Biogenouest Genomics and Health Genomic Platform Biosit Core Facility for technical support.

Funding

MS and YA were supported by the Region Bretagne grants SAD SARS #8254 and SAD SARS_2 #9181.

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Authors and Affiliations

  1. Inserm U1230 Biochimie Pharmaceutique, Université de Rennes 1, 2 Avenue du Professeur Léon Bernard, 35043, Rennes, France

    M. Sassi, B. Felden, M. Revest, P. Tattevin, Y. Augagneur & P.-Y. Donnio

  2. Service de Maladies Infectieuses et Réanimation Médicale, Centre Hospitalier Universitaire, 35033, Rennes, France

    M. Revest & P. Tattevin

  3. CIC Inserm 1414, Université Rennes 1, Centre Hospitalier Universitaire, 35033, Rennes, France

    M. Revest & P. Tattevin

  4. Service de Bactériologie-Hygiène Hospitalière, Centre Hospitalier Universitaire, 35033, Rennes, France

    P.-Y. Donnio

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  1. M. Sassi
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  2. B. Felden
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Correspondence to B. Felden, Y. Augagneur or P.-Y. Donnio.

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Brice Felden, Yoann Augagneur and Pierre-Yves Donnio were co–principal investigators.

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Sassi, M., Felden, B., Revest, M. et al. An outbreak in intravenous drug users due to USA300 Latin-American variant community-acquired methicillin-resistant Staphylococcus aureus in France as early as 2007. Eur J Clin Microbiol Infect Dis 36, 2495–2501 (2017). https://doi.org/10.1007/s10096-017-3092-7

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