ArticleGenome medicine2021
Drivers of methicillin-resistant Staphylococcus aureus (MRSA) lineage replacement in China.
Article in Genome medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers.
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Who cites it
47 citing papers in PubMed.
- Article
- Genomic and virulence characteristics of Staphylococcus aureus isolates from foodborne outbreak cases.BMC microbiology · 2026Article
- Prevalence and antimicrobial susceptibility ofOne health (Amsterdam, Netherlands) · 2026Article
- Time-associated phenotypic changes related to virulence and immune interaction of Staphylococcus aureus during relapsing infection within individual hosts.BMC infectious diseases · 2026Article
- Five-decade global expansion of Staphylococcus argenteus ST2250 shapes antimicrobial resistance dynamics.npj antimicrobials and resistance · 2026Article
- Global emergence and evolution ofmSystems · 2026Article
- Clade-specific adaptation and global spread ofmSystems · 2026Article
- Prevalence, Antimicrobial Resistance, and Molecular Characteristics of MRSA in Saudi Arabia: A Retrospective Study.Microorganisms · 2026Article
- Genomic and epidemiological insights into the emergence and dominance of MRSA clones in Riyadh's healthcare facilities.Scientific reports · 2026Article
- Fluoroquinolone resistance without fluoroquinolone use; the genie is truly out of the bottle.Frontiers in microbiology · 2026Review
- MRSA in Tibet: high prevalence driven by the epidemic clone CC59-ST59-SCCFrontiers in microbiology · 2026Article
- Antibiotic resistance characteristics, molecular typing, and potential transmission reservoirs of methicillin-resistantFrontiers in microbiology · 2026Article
- Genomic driver underlies clonal shift of methicillin-resistantEmerging microbes & infections · 2025Article
- Molecular epidemiology and geographical variation of methicillin-resistant Staphylococcus aureus: a multicentre study across Xinjiang, China.BMC microbiology · 2025Article
- Confronting the Antimicrobial Resistance Crisis in China: Emerging Superbugs, Genomic Surveillance, and Innovative Countermeasures.China CDC weekly · 2025Article
- Antibiotic Resistance, Biofilm Formation, and Molecular Epidemiology of FoodborneFood science & nutrition · 2025Article
- Article
- Inhibiting Staphylococcus aureus Virulence Factors: Advances in Traditional Chinese Medicines and Active Compounds.Current microbiology · 2025Review
- Methicillin-sensitiveMicrobial genomics · 2025Article
- ESKAPE in China: epidemiology and characteristics of antibiotic resistance.Emerging microbes & infections · 2024Review
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15 authors.
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Abstract
backgroundMethicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen subdivided into lineages termed sequence types (STs). Since the 1950s, successive waves of STs have appeared and replaced previously dominant lineages. One such event has been occurring in China since 2013, with community-associated (CA-MRSA) strains including ST59 largely replacing the previously dominant healthcare-associated (HA-MRSA) ST239. We previously showed that ST59 isolates tend to have a competitive advantage in growth experiments against ST239. However, the underlying genomic and phenotypic drivers of this replacement event are unclear.
methodsHere, we investigated the replacement of ST239 using whole-genome sequencing data from 204 ST239 and ST59 isolates collected in Chinese hospitals between 1994 and 2016. We reconstructed the evolutionary history of each ST and considered two non-mutually exclusive hypotheses for ST59 replacing ST239: antimicrobial resistance (AMR) profile and/or ability to colonise and persist in the environment through biofilm formation. We also investigated the differences in cytolytic activity, linked to higher virulence, between STs. We performed an association study using the presence and absence of accessory virulence genes.
resultsST59 isolates carried fewer AMR genes than ST239 and showed no evidence of evolving towards higher AMR. Biofilm production was marginally higher in ST59 overall, though this effect was not consistent across sub-lineages so is unlikely to be a sole driver of replacement. Consistent with previous observations of higher virulence in CA-MRSA STs, we observed that ST59 isolates exhibit significantly higher cytolytic activity than ST239 isolates, despite carrying on average fewer putative virulence genes. Our association study identified the chemotaxis inhibitory protein (chp) as a strong candidate for involvement in the increased virulence potential of ST59. We experimentally validated the role of chp in increasing the virulence potential of ST59 by creating Δchp knockout mutants, confirming that ST59 can carry chp without a measurable impact on fitness.
conclusionsOur results suggest that the ongoing replacement of ST239 by ST59 in China is not associated to higher AMR carriage or biofilm production. However, the increase in ST59 prevalence is concerning since it is linked to a higher potential for virulence, aided by the carriage of the chp gene.
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