Emergence of livestock-associated MRSA isolated from cystic fibrosis patients: Result of a Belgian national survey

M Dodémont, M A Argudín, J Willekens, E Vanderhelst, D Pierard, V Y Miendje Deyi, L Hanssens, H Franckx, P Schelstraete, I Leroux-Roels, C Nonhoff, A Deplano, C Knoop, A Malfroot, O Denis

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BACKGROUND: This study aims to determine the prevalence and characteristics of Staphylococcus aureus in Belgian cystic fibrosis (CF) patients.

METHODS: Non-duplicate respiratory samples from 510 CF-patients (2012-2013) were examined. One isolate per patient was analysed unless different phenotypes were recovered. Isolates were investigated for mecA/mecC, toxins presence, spa-typing, MLST and SCCmec-typing. Potential livestock-associated (LA) isolates were examined for their immune-evasion-cluster (IEC) genes.

RESULTS: S. aureus (n = 380), including 41 small-colony variants (SCVs), were isolated from 66.7% patients. The prevalence of methicillin-resistant S. aureus (MRSA) colonization was 4.9%. Two MRSA isolates carried toxic shock syndrome toxin 1 (TSST-1). Most MRSA (65%) belonged to two nosocomial epidemic clones (CC5, CC8) widespread in Belgium. Methicillin susceptible S. aureus (MSSA) showed great genetic diversity. Five of 33 isolates belonging to potential LA-lineages were IEC negative, including three methicillin-resistant isolates, suggesting an animal origin.

CONCLUSIONS: The MRSA-prevalence in Belgian CF-patients remained constant (2001-2013), but SCV-prevalence increased. Most MRSA belonged to health-care-associated clones. Three patients carrying LA-MRSA were found, requiring further investigation to determine the risk factors for LA-MRSA acquisition.

Original languageEnglish
Pages (from-to)86-93
Number of pages8
JournalJournal of Cystic Fibrosis
Issue number1
Early online date24 May 2018
Publication statusPublished - Jan 2019


  • CC398
  • Small colony variant
  • spa-typing


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