Community and nosocomial transmission of Panton–Valentine leucocidin-positive community-associated meticillin-resistant Staphylococcus aureus: implications for healthcare

Orendi, J M; Coetzee, Nic; Ellington, Matthew J.; Boakes, Eve; Cookson, Barry; Hardy, Katherine; Hawkey, Peter M.; Kearns, Angela

doi:10.1016/j.jhin.2010.03.023

Cited by 34 publications

(28 citation statements)

References 24 publications

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“…This rationale is supported by reports on (1) recurrent skin infection being linked transmission of usa300 latin american variant 883 to PVL-positive S. aureus nasal colonization 3,4 and (2) nosocomial outbreaks of epidemic PVL + CA-MRSA other than USA300 being fueled by colonized individuals that suffer from recurrent SSTI. 9 Although the impact of the proposed approach has not been systematically evaluated, these observations in conjunction with our report suggests that a history of recurrent SSTI is a potent marker for colonization with epidemic CA-MRSA and could thus prove useful for its early detection and timely eradication in newly admitted patients before invasion of epidemic CA-MRSA into European hospitals becomes an unchangeable fact. A recent report of a USA300 outbreak in a Belgium hospital demonstrates the urgency of this issue 10 and justifies taking measures before direct evidence is available.…”

Section: Mrsa Colonizationmentioning

confidence: 52%

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Nurjadi

Klein

Zimmermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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Section: Mrsa Colonizationmentioning

confidence: 52%

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Nurjadi

Klein

Zimmermann

et al. 2017

Infect. Control Hosp. Epidemiol.

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“…CA-MRSA strains have most commonly been SCCmec type IV and Panton-Valentine leukocidin positive, while HA-MRSA strains have most commonly been SCCmec types I, II, and III and Panton-Valentine leukocidin negative. However, recent studies describing CA-MRSA strains in the hospital setting (17,27,33) suggest that clinical presentation and epidemiologic risk factors are no longer sufficient to reliably define molecular strain types. CA-MRSA infections have been demonstrated to be more common in children, especially children less than 2 years of age (12).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factor Analysis for Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Children Attending Child Care Centers

et al. 2011

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Children attending child care centers (CCCs) are at increased risk for infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). Nasal colonization often precedes infection, and MRSA colonization has been associated with increased infection risk. Community-associated MRSA (CA-MRSA) has caused increased MRSA infections in the general population, including children. Little is known about the frequency of MRSA nasal colonization in young children, particularly in those attending CCCs where disease transmission is common. We sampled the nares of 1,163 children in 200 classrooms from 24 CCCs in North Carolina and Virginia to assess S. aureus colonization. MRSA strains were molecularly analyzed for staphylococcal cassette chromosome mec (SCCmec) type, Panton-Valentine leukocidin status, and multilocus sequence type. A case-control study was performed to identify risk factors for MRSA colonization. We found that 18.1% children were colonized with S. aureus and 1.3% with MRSA. Molecular analysis of the MRSA strains identified 47% as CA-MRSA and 53% as health care-associated MRSA (HA-MRSA). Although two centers had multiple children colonized with MRSA, genotyping indicated that no transmission had occurred within classrooms. The case-control study did not detect statistically significant risk factors for MRSA colonization. However, MRSA-colonized children were more likely to be nonwhite and to have increased exposure to antibiotics and skin infections in the home. Both CA-MRSA and HA-MRSA strains were found colonizing the nares of children attending CCCs. The low frequency of colonization observed highlights the need for a large multicenter study to determine risk factors for MRSA colonization and subsequent infection in this highly susceptible population.

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“…The England and Wales Staphylococcus Reference Unit (SRU) receives isolates from diverse infection types for epidemiological typing and outbreak investigation. In this work, 114 MRSA strains previously characterized by multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), SCCmec, spa, and arginine catabolic mobile element (ACME) PCR (19) and belonging to MLST clonal complex 1 (CC1), CC5, CC22, CC30, CC59, CC80, and CC88 and sequence type 93 (ST93) (3,(16)(17)(18)32) were selected to maximize genetic and geographic diversity.…”

Section: Methodsmentioning

confidence: 99%

Distinct Bacteriophages Encoding Panton-Valentine Leukocidin (PVL) among International Methicillin-Resistant Staphylococcus aureus Clones Harboring PVL

et al. 2011

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Genetically diverse community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) can harbor a bacteriophage encoding Panton-Valentine leukocidin (PVL) lysogenized into its chromosome (prophage). Six PVL phages (⌽PVL, ⌽108PVL, ⌽SLT, ⌽Sa2MW, ⌽Sa2USA, and ⌽Sa2958) are known, and single-nucleotide polymorphisms (SNPs) in the PVL genes have been reported. We sought to determine the distribution of lysogenized PVL phages among MRSA strains with PVL (PVL-MRSA strains), the PVL gene sequences, and the chromosomal phage insertion sites in 114 isolates comprising nine clones of PVL-MRSA that were selected for maximal underlying genetic diversity. The six PVL phages were identified by PCR; ⌽Sa2USA was present in the highest number of different lineages (multilocus sequence type clonal complex 1 [CC1], CC5, CC8, and sequence type 93 [ST93]) (n ‫؍‬ 37 isolates). Analysis of 92 isolates confirmed that PVL phages inserted into the same chromosomal insertion locus in CC22, -30, and -80 but in a different locus in isolates of CC1, -5, -8, -59, and -88 and ST93 (and CC22 in two isolates). Within the two different loci, specific attachment motifs were found in all cases, although some limited inter-and intralineage sequence variation occurred. Overall, lineage-specific relationships between the PVL phage, the genes that encode the toxin, and the position at which the phage inserts into the host chromosome were identified. These analyses provide important insights into the microepidemiology of PVL-MRSA, will prove a valuable adjunct in outbreak investigation, and may help predict the emergence of new strains.

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Community and nosocomial transmission of Panton–Valentine leucocidin-positive community-associated meticillin-resistant Staphylococcus aureus: implications for healthcare

Cited by 34 publications

References 24 publications

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Transmission of ST8-USA300 Latin American Variant Methicillin-Resistant Staphylococcus aureus on a Neonatal Intensive Care Unit: Recurrent Skin and Soft- Tissue Infections as a Marker for Epidemic Community-Associated-MRSA Colonization

Prevalence and Risk Factor Analysis for Methicillin-Resistant Staphylococcus aureus Nasal Colonization in Children Attending Child Care Centers

Distinct Bacteriophages Encoding Panton-Valentine Leukocidin (PVL) among International Methicillin-Resistant Staphylococcus aureus Clones Harboring PVL

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