Genomic and epidemiological evidence of a dominant Panton-Valentine leucocidin-positive Methicillin Resistant Staphylococcus aureus lineage in Sri Lanka with spread to the United Kingdom and Australia

To investigate the genetic relatedness of the CC5 PVL-positive isolates circulating in Sri Lanka, Whole Genome Sequencing was performed at Public Health England (PHE) on 34 Sri Lankan isolates selected on the basis of diverse clinical symptoms and spa type using illumina technologies. In addition, contemporaneous lineage-matched isolates held in the PHE archives were included and comprised isolates from patients with known links to Sri Lanka (11 CC5 PVL-positive MRSA isolates) and patients with no known links to Sri Lanka (89 isolates: 24 CC5 PVL-positive MRSA, 30 CC5 PVL-negative MRSA, five CC5 PVL-positive MSSA and 30 CC5 PVL-negative MSSA). Fourteen additional CC5 PVL-positive isolates originated from Australia were sequenced at Murdoch university.