Outbreaks of a Methicillin-Resistant Staphylococcus aureus Clone ST398-t011 in a Hungarian Equine Clinic: Emergence of Rifampicin and Chloramphenicol Resistance After Treatment with These Antibiotics.
Abstract: Between July 2011 and May 2016, a total of 40 Staphylococcus aureus strains originating from 36 horses were confirmed as methicillin resistant (methicillin-resistant Staphylococcus aureus [MRSA]) in a university equine clinic. An additional 10 MRSA strains from 36 samples of clinic workers were obtained in October 2017. The first equine isolate represented the sequence type ST398, spa-type t011, and SCCmec IV. This isolate was resistant to a wide spectrum of antimicrobial agents. MRSA strains with the same genotype and with very similar resistance profiles were isolated on 21 more occasions from September 2013 to September 2014. A second outbreak occurred from May 2015 until May 2016. The first isolate in this second outbreak shared the same genotype, but was additionally resistant to chloramphenicol. The second isolate from August 2015 also showed resistance to rifampicin. The clone was isolated 18 times. Most of the human isolates shared the same genotype as the isolates from horses and their resistance patterns showed only slight differences. We can conclude that the MRSA-related cases at the Department and Clinic of Equine Medicine were all nosocomial infections caused by the same clonal lineage belonging to the clonal complex 398. The clonal complex 398 of equine origin is reported for the first time in Hungary. In addition, our observation of the emergence of new resistance to antimicrobial agents within the clonal lineage after treatment with antibiotics is of concern. Strict hygiene regulations have been introduced to lower the incidence of MRSA isolation and the related clinical disease.
Publication Date: 2019-05-08 PubMed ID: 31066624DOI: 10.1089/mdr.2018.0384Google Scholar: Lookup
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- Journal Article
Summary
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This study uncovers the occurrence of infections by a methicillin-resistant Staphylococcus aureus (MRSA) clone in a Hungarian equine clinic from 2011 to 2016, and the resulting development of resistance to other antibiotics after treatments.
About the Study
- The research was conducted between July 2011 and May 2016, and later an additional collection of strains in October 2017, in a Hungarian university equine clinic where a total of 40 MRSA strains from 36 horses were confirmed.
- An additional 10 MRSA strains were later obtained from 36 samples taken from clinic workers, suggesting the bacteria also affected the clinic’s human population. This underlines the zoonotic nature of the bacteria, meaning it can be transmitted from animals to humans.
Findings of the Study
- The initial equine isolate displayed resistance to a wide array of antimicrobial agents, suggesting a strong resilience against treatments.
- Strains with very similar resistance profiles were isolated from horses on 21 more occasions from 2013 to 2014, implying a persistent presence of the pathogen in the clinic.
- A second cycle of isolation occurred from May 2015 to 2016; the first isolate in this second outbreak showed an additional resistance to chloramphenicol while the second isolate exhibited resistance to rifampicin — two antibiotics commonly used for MRSA.
- The resistance patterns of the human isolates were similar to the equine strains, further confirming the transmission between horses and humans.
- All of the MRSA-related cases at the clinic were recognized as nosocomial infections, which are infections that originate within a healthcare facility.
The Significance of the Findings
- This is the first time that the clonal complex 398 of equine origin is reported in Hungary, increasing the understanding of the distribution of MRSA strains globally.
- The emergence of resistance to additional antibiotics within the MRSA strains after treatment is alarming as it suggests that the bacteria can develop resilience against possible treatments, presenting challenges to public health.
- In response to the findings, strict hygiene regulations have been implemented in the clinic to control the incidence of MRSA isolation and the related clinical disease.
Cite This Article
APA
Albert E, Biksi I, Német Z, Csuka E, Kelemen B, Morvay F, Bakos Z, Bodó G, Tóth B, Collaud A, Rossano A, Perreten V.
(2019).
Outbreaks of a Methicillin-Resistant Staphylococcus aureus Clone ST398-t011 in a Hungarian Equine Clinic: Emergence of Rifampicin and Chloramphenicol Resistance After Treatment with These Antibiotics.
Microb Drug Resist, 25(8), 1219-1226.
https://doi.org/10.1089/mdr.2018.0384 Publication
Researcher Affiliations
- Diagnostic Laboratory, Department and Clinic of Production Animal Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Diagnostic Laboratory, Department and Clinic of Production Animal Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Diagnostic Laboratory, Department and Clinic of Production Animal Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Diagnostic Laboratory, Department and Clinic of Production Animal Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Diagnostic Laboratory, Department and Clinic of Production Animal Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Department and Clinic of Equine Medicine, University of Veterinary Medicine Budapest, Üllő, Hungary.
- Vetsuisse Faculty, Institute of Veterinary Bacteriology, University of Bern, Bern, Switzerland.
- Vetsuisse Faculty, Institute of Veterinary Bacteriology, University of Bern, Bern, Switzerland.
- Vetsuisse Faculty, Institute of Veterinary Bacteriology, University of Bern, Bern, Switzerland.
MeSH Terms
- Animals
- Anti-Bacterial Agents / pharmacology
- Chloramphenicol / pharmacology
- Chloramphenicol Resistance / drug effects
- Chloramphenicol Resistance / genetics
- Cross Infection / epidemiology
- Cross Infection / microbiology
- Cross Infection / veterinary
- Disease Outbreaks
- Genotype
- Horses / microbiology
- Hungary
- Methicillin-Resistant Staphylococcus aureus / drug effects
- Methicillin-Resistant Staphylococcus aureus / genetics
- Rifampin / pharmacology
- Staphylococcal Infections / epidemiology
- Staphylococcal Infections / microbiology
- Staphylococcal Infections / veterinary
Citations
This article has been cited 10 times.- Jafari H, Abebe BK, Cong L, Ahmed Z, Zhaofei W, Sun M, Muhatai G, Chuzhao L, Dang R. Review: Genomic insights into the adaptive traits and stress resistance in modern horses. Stress Biol 2026 Jan 12;6(1):5.
- Albert E, Sipos R, Perreten V, Tóth Á, Ungvári E, Papp M, Dán Á, Biksi I. High Prevalence of Livestock-Associated Methicillin-Resistant Staphylococcus aureus in Hungarian Pig Farms and Genomic Evidence for the Spillover of the Pathogen to Humans. Transbound Emerg Dis 2023;2023:5540019.
- Papouskova A, Drabkova Z, Brajerova M, Krutova M, Cizek A, Tkadlec J. The circulation of methicillin-resistant Staphylococcus aureus between humans, horses and the environment at the equine clinic. J Antimicrob Chemother 2024 Nov 4;79(11):2901-2905.
- Fernandez JE, Egli A, Overesch G, Perreten V. Time-calibrated phylogenetic and chromosomal mobilome analyses of Staphylococcus aureus CC398 reveal geographical and host-related evolution. Nat Commun 2024 Jul 1;15(1):5526.
- Albert E, Sahin-Tóth J, Horváth A, Papp M, Biksi I, Dobay O. Genomic Evidence for Direct Transmission of mecC-MRSA between a Horse and Its Veterinarian. Antibiotics (Basel) 2023 Feb 17;12(2).
- Silva V, Monteiro A, Pereira JE, Maltez L, Igrejas G, Poeta P. MRSA in Humans, Pets and Livestock in Portugal: Where We Came from and Where We Are Going. Pathogens 2022 Sep 27;11(10).
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- Guo Y, Ryan U, Feng Y, Xiao L. Association of Common Zoonotic Pathogens With Concentrated Animal Feeding Operations. Front Microbiol 2021;12:810142.
- Little SV, Hillhouse AE, Lawhon SD, Bryan LK. Analysis of Virulence and Antimicrobial Resistance Gene Carriage in Staphylococcus aureus Infections in Equids Using Whole-Genome Sequencing. mSphere 2021 Aug 25;6(4):e0019620.
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