Community‐acquired, methicillin‐resistant Staphylococcus aureus isolated from children with community‐onset pneumonia in China

Abstract

Community-acquired, methicillin-resistant Staphylococcus aureus (CA-MRSA) has been associated with morbidity and mortality in various countries. In this study, we characterized the molecular and clinical features of pediatric CA-MRSA pneumonia in China. Between June 2006 and February 2008, 55 previously healthy children confined in eight hospitals countrywide were found to be afflicted with CA-MRSA pneumonia. A total of 55 strains collected from these children were analyzed by multilocus sequence typing (MLST), Staphylococcus cassette chromosome mec (SCCmec) typing, and spa typing. The Panton-Valentine leukocidin (PVL) gene was also detected. Overall, nine STs were obtained, with ST59 (40.4%) established to be the most prevalent type. We first registered the new ST1409 from a child with necrotizing pneumonia. SCCmecIVa was the most predominant type, followed by SCCmec type V. Twelve spa types were identified, of which one new spa type, t5348, was first detected and registered. One typical livestock-associated spa type, t034, was found in a 4-month-old girl living in the countryside. We also found that 40% of those isolates were PVL-positive. In addition, the median age of the children in this study was 10 months. A total of 69% (38/55) of the children with community-acquired pneumonia (CAP) had preceding influenza or influenza-like illness, and three ST910-MRSA-IV strains (PVL gene-positive) were associated with severe necrosis. The results indicated that the recent CA-MRSA found in Chinese children with CAP was largely associated with the spread of the ST59-MRSA-IV clone, and most of the PVL-positive strains in this study did not cause necrotic cases.

Panton–Valentine leukocidin-associated Staphylococcus aureus necrotizing pneumonia in infants: a report of four cases and review of the literature

“…Six of the ten infants died [13,16,17,21,30,31,35,36]. There are other reports of PVL-associated S. aureus pneumonia in larger cohorts; some of which include infants [2,10,37].…”

Characterization of Staphylococcus aureus Strains Associated with Food Poisoning in Shenzhen, China

“…The ST6 MRSA strain has rarely been isolated, but community-associated MRSA (CA-MRSA) clones were reported in Kuwait hospitals (32), Japan (12), and Lebanon (31). According to previous research, ST6 is not the predominant S. aureus lineage that is observed in hospitals and animals in China (6,8,9,35,36,38,40,41). Why ST6 MSSA became the dominant ST that causes SFP and whether ST6 was the unique ST in food products or among SFP isolates in China should be investigated further.…”

Community-associated meticillin-resistant Staphylococcus aureus in children in Taiwan, 2000s

“…Of them, the 'Taiwan clone' (ST59/PFGE type D/SCCmec V T /PVL-positive) was amongst the most prevalent. This virulent clone was also identified in Hong Kong, China, Vietnam, Singapore and Japan in the past decade [34,79,80,[82][83][84]. In the USA, CA-MRSA ST59/SCCmec IV, designated as PFT USA1000, was prevalent in selected populations, including human immunodeficiency virus (HIV) carriers, intravenous drug users and homeless persons in San Francisco [78].…”