Journal of global antimicrobial resistance · 2026
High prevalence of hypervirulent Staphylococcus aureus CC22-t309 in Pediatric Osteomyelitis and Septic Arthritis in China.
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Ye Xiaoying, Li Huiwen, Wang Naike, Zhang Haodong, Wang Chuanqing, Fu Pan, Ning Bo
Аннотация
OBJECTIVES: This study aimed to elucidate the molecular epidemiology, virulence factors, and antimicrobial resistance profiles of Staphylococcus aureus isolated from children with osteomyelitis and septic arthritis (OM-SA) in China.
METHODS: A total of 68 S. aureus isolates were collected from pediatric patients with OM-SA in Shanghai, China, with 100 strains from children with other infections serving as controls. We performed a systematic analysis on all strains by integrating clinical metadata, whole-genome sequencing, and antimicrobial susceptibility testing.
RESULTS: Among S. aureus isolates from OM-SA cases, CC22-t309 was the dominant clone (32.3%), followed by CC59-t437 (17.6%). The prevalence of CC22-t309 in OM-SA was much higher than that in the control (32.3% vs. 8.0%, p<0.001). OM-SA patients with CC22-t309 infection presented much higher inflammatory markers than those infected with other clones (p<0.05). Notably, CC22-t309 from OM-SA exhibited higher carriage of virulence factors, including Panton-Valentine leukocidin (pvl, 100%), collagen adhesin (cna, 86.4%), and fibronectin-binding proteins (fnbA/B, 77.3%), compared with other clones (pvl, 0∼66.7%; cna, 0∼13.8%; fnbA/B, 0∼24.1%; p < 0.05). Within CC22-t309 clone, the carriage of pvl, fnbB and fnbA showed no difference between OM-SA and control group (pvl: 100% vs. 87.5%; fnbB: 77.3% vs. 85.7%; fnbA: 77.3% vs. 37.5%; p >0.05). However, the prevalence of cna in OM-SA was significantly higher than that in the control group (86.4% vs. 37.5%, p = 0.015). Furthermore, CC22-t309 isolates displayed a multidrug-resistant phenotype against β-lactams, macrolides, and lincosamides.
CONCLUSION: We identify the hypervirulent and multidrug-resistant CC22-t309 as a high-risk S. aureus lineage associated with pediatric OM-SA.
METHODS: A total of 68 S. aureus isolates were collected from pediatric patients with OM-SA in Shanghai, China, with 100 strains from children with other infections serving as controls. We performed a systematic analysis on all strains by integrating clinical metadata, whole-genome sequencing, and antimicrobial susceptibility testing.
RESULTS: Among S. aureus isolates from OM-SA cases, CC22-t309 was the dominant clone (32.3%), followed by CC59-t437 (17.6%). The prevalence of CC22-t309 in OM-SA was much higher than that in the control (32.3% vs. 8.0%, p<0.001). OM-SA patients with CC22-t309 infection presented much higher inflammatory markers than those infected with other clones (p<0.05). Notably, CC22-t309 from OM-SA exhibited higher carriage of virulence factors, including Panton-Valentine leukocidin (pvl, 100%), collagen adhesin (cna, 86.4%), and fibronectin-binding proteins (fnbA/B, 77.3%), compared with other clones (pvl, 0∼66.7%; cna, 0∼13.8%; fnbA/B, 0∼24.1%; p < 0.05). Within CC22-t309 clone, the carriage of pvl, fnbB and fnbA showed no difference between OM-SA and control group (pvl: 100% vs. 87.5%; fnbB: 77.3% vs. 85.7%; fnbA: 77.3% vs. 37.5%; p >0.05). However, the prevalence of cna in OM-SA was significantly higher than that in the control group (86.4% vs. 37.5%, p = 0.015). Furthermore, CC22-t309 isolates displayed a multidrug-resistant phenotype against β-lactams, macrolides, and lincosamides.
CONCLUSION: We identify the hypervirulent and multidrug-resistant CC22-t309 as a high-risk S. aureus lineage associated with pediatric OM-SA.