@article{dbbee8da68674b608e8957756be7b50c,
title = "Whole-genome sequencing of Staphylococcus epidermidis bloodstream isolates from a prospective clinical trial reveals that complicated bacteraemia is caused by a limited number of closely related sequence types",
abstract = "Objectives: The significance of isolating Staphylococus epidermidis from a blood culture is highly heterogeneous, ranging from contamination to an indication of a serious infection. Herein we sought to determine whether there is a relationship between S. epidermidis genotype and clinical severity of bacteraemia. Methods: S. epidermidis bacteraemias from a prospective, multicentre trial at 15 centres in the United States and one in Spain were classified as simple (including possible contamination), uncomplicated, and complicated. Whole-genome sequencing (WGS) was performed on 161 S. epidermidis isolates, and clinical outcomes were correlated with genotypic information. Results: A total of 49 S. epidermidis sequence types (STs) were identified. Although strains of all 49 STs were isolated from patients with either simple or uncomplicated infection, all strains causing complicated infections were derived from five STs: ST2, ST5, ST7, ST16, and ST32. ST2 and ST5 isolates were significantly more likely to cause uncomplicated and complicated bloodstream infections compared to simple bacteraemia (odds ratio 2.0, 95%CI 1.1–3.9, p 0.04). By multivariate regression analysis, having an ST2 or ST5 S. epidermidis bacteraemia was an independent predictor of complicated bloodstream infection (odds ratio 3.7, 95%CI 1.2–11.0, p 0.02). ST2/ST5 strains carried larger numbers of antimicrobial resistance determinants compared to non-ST2/ST5 isolates (6.34 ± 1.5 versus 4.4 ± 2.5, p < 0.001). Conclusion: S. epidermidis bacteraemia was caused by a genetically heterogeneous group of organisms, but only a limited number of STs—particularly multidrug-resistant ST2 and ST5 strains—caused complicated infections.",
keywords = "Antimicrobial resistance, Genotype:phenotype correlation, Phylogenomics, Staphylococcus epidermidis, Whole-genome sequencing",
author = "Samuel Shelburne and Dib, {R. W.} and Endres, {B. T.} and R. Reitzel and X. Li and A. Kalia and P. Sahasrabhojane and Chaftari, {A. M.} and R. Hachem and Vargas-Cruz, {N. S.} and Y. Jiang and K. Garey and Fowler, {V. G.} and Holland, {T. L.} and J. Gu and W. Miller and A. Sakurai and Arias, {C. A.} and Aitken, {S. L.} and Greenberg, {D. E.} and J. Kim and Flores, {A. R.} and I. Raad",
note = "Funding Information: I. Raad reports that he receives royalties related to patents on which he is inventor or co-inventor from Cook, Citius, and Novel Anti-Infective Technologies. T.L. Holland reports serving as a consultant for Basilea Pharmaceutica, Genentech, Motif Bio, The Medicines Company, and Theravance. V.G. Fowler reports serving as chair of the V710 Scientific Advisory Committee for Merck; receiving grant support from Basilea, Cerexa/Actavis, Pfizer, Advanced Liquid Logics, National Institutes of Health (NIH), MedImmune, Cubist/Merck, Karius, Contrafect, Regeneron, and Genentech; having NIH STTR/SBIR grants pending with Affinergy, Locus, and Medical Surface Inc; serving as a paid consultant for Achaogen, Astellas, Arsanis, Affinergy, Basilea, Bayer, Cerexa, Contrafect, Cubist, Debiopharm, Durata, Grifols, Genentech, MedImmune, Merck, The Medicines Company, Pfizer, Novartis, Novadigm, Theravance, xBiotech, and Regeneron; receiving honoraria from Theravance, and Green Cross; and having a patent pending in sepsis diagnostics. Financial support for this study was provided by award HHSN272200900023C from the National Institutes of Health (NIH). V.G. Fowler was supported by NIH grant K24 AI093969. The sponsor had no role in the study design, collection, analysis, or interpretation of data, writing of the report, or decision to submit the report for publication. Sequencing was performed at the MDACC DNA sequencing facility which is supported by the National Cancer Institute (grant number P30-CA016672 via the Bioinformatics Shared Resource). Funding Information: I. Raad reports that he receives royalties related to patents on which he is inventor or co-inventor from Cook, Citius, and Novel Anti-Infective Technologies. T.L. Holland reports serving as a consultant for Basilea Pharmaceutica, Genentech, Motif Bio, The Medicines Company, and Theravance. V.G. Fowler reports serving as chair of the V710 Scientific Advisory Committee for Merck; receiving grant support from Basilea , Cerexa/Actavis , Pfizer , Advanced Liquid Logics , National Institutes of Health (NIH), MedImmune , Cubist/Merck , Karius , Contrafect , Regeneron , and Genentech ; having NIH STTR/SBIR grants pending with Affinergy , Locus , and Medical Surface Inc ; serving as a paid consultant for Achaogen, Astellas, Arsanis, Affinergy, Basilea, Bayer, Cerexa, Contrafect, Cubist, Debiopharm, Durata, Grifols, Genentech, MedImmune, Merck, The Medicines Company, Pfizer, Novartis, Novadigm, Theravance, xBiotech, and Regeneron; receiving honoraria from Theravance, and Green Cross; and having a patent pending in sepsis diagnostics. Financial support for this study was provided by award HHSN272200900023C from the National Institutes of Health (NIH). V.G. Fowler was supported by NIH grant K24 AI093969 . The sponsor had no role in the study design, collection, analysis, or interpretation of data, writing of the report, or decision to submit the report for publication. Sequencing was performed at the MDACC DNA sequencing facility which is supported by the National Cancer Institute (grant number P30-CA016672 via the Bioinformatics Shared Resource). Publisher Copyright: {\textcopyright} 2019 European Society of Clinical Microbiology and Infectious Diseases",
year = "2020",
month = may,
doi = "10.1016/j.cmi.2019.10.008",
language = "English (US)",
volume = "26",
pages = "646.e1--646.e8",
journal = "Clinical Microbiology and Infection",
issn = "1198-743X",
publisher = "Elsevier Limited",
number = "5",
}