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Subpopulations of Staphylococcus aureus clonal complex 121 are associated with distinct clinical entities.
[pyomyositis]
We
investigated
the
population
structure
of
Staphylococcus
aureus
clonal
complex
CC
121
by
mutation
discovery
at
115
genetic
housekeeping
loci
from
each
of
154
isolates
,
sampled
on
five
continents
between
1953
and
2009
.
In
addition
,
we
pyro-sequenced
the
genomes
from
ten
representative
isolates
.
The
genome-
wide
SNPs
that
were
ascertained
revealed
the
evolutionary
history
of
CC
121
,
indicating
at
least
six
major
clades
(
A
to
F
)
within
the
clonal
complex
and
dating
its
most
recent
common
ancestor
to
the
pre-antibiotic
era
.
The
toxin
gene
complement
of
CC
121
isolates
was
correlated
with
their
SNP-based
phylogeny
.
Moreover
,
we
found
a
highly
significant
association
of
clinical
phenotypes
with
phylogenetic
affiliations
,
which
is
unusual
for
S
.
aureus
.
All
isolates
evidently
sampled
from
superficial
infections
(
including
staphylococcal
scalded
skin
syndrome
,
bullous
impetigo
,
exfoliative
dermatitis
,
conjunctivitis
)
clustered
in
clade
F
,
which
included
the
European
epidemic
fusidic-acid
resistant
impetigo
clone
(
EEFIC
)
.
In
comparison
,
isolates
from
deep
-seated
infections
(
abscess
,
furuncle
,
pyomyositis
,
necrotizing
pneumonia
)
were
disseminated
in
several
clades
,
but
not
in
clade
F
.
Our
results
demonstrate
that
phylogenetic
lineages
with
distinct
clinical
properties
exist
within
an
S
.
aureus
clonal
complex
,
and
that
SNPs
serve
as
powerful
discriminatory
markers
,
able
to
identify
these
lineages
.
All
CC
121
genomes
harboured
a
41
-
kilobase
prophage
that
was
dissimilar
to
S
.
aureus
phages
sequenced
previously
.
Community
-associated
MRSA
and
MSSA
from
Cambodia
were
extremely
closely
related
,
suggesting
this
MRSA
arose
in
the
region
.
Diseases
Validation
Diseases presenting
"fusidic-acid resistant impetigo clone"
symptom
pyomyositis
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