Epidemiology of Staphylococcus aureus food isolates: Comparison of conventional methods with whole genome sequencing typing methods.

A variety of methods exists for typing bacteria. However, guidelines for the application and interpretation of typing tools in epidemiologic investigations of Staphylococcus aureus are lacking. This study aimed to identify appropriate typing methods for S. aureus population studies and outbreak investigation. We compared pulsed-field gel electrophoresis (PFGE), seven loci multi-locus sequence typing (MLST), core genome MLST (cgMLST), core single nucleotide polymorphism (cSNP), and enterotoxin (se/SE) profiles on 351 S. aureus isolates. The discriminatory power, concordance, and congruence of typing results were assessed. cgMLST, cSNP, and PFGE yielded the highest discrimination value, followed by se/SE typing and MLST. The best concordance of results was found between cgMLST and cSNP, while the best congruence was observed for cgMLST and cSNP with all methods, followed by PFGE with MLST. The strengths and weaknesses of each method are highlighted. For population structure, cgMLST and cSNP performed better than PFGE and MLST in terms of resolution of clusters and in phylogenetic inference. Enterotoxin profiles matched with MLST groups, suggesting the use of se/SE typing to predict MLST results. For the retrospective analysis of 31 outbreaks, all methods performed almost equally to discriminate epidemiologically related strains and can be used to unambiguously distinguish outbreak strains.