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
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Diseases presenting "bullous impetigo" symptom

pyomyositis

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