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

Huang, Yhu-Chering; Chen, Chih‐Jung

doi:10.1016/j.ijantimicag.2011.01.011

Cited by 97 publications

(99 citation statements)

References 77 publications

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“…The present study found a high rate of mecA-positive strains in S. aureus isolates with oxacillin MIC in the susceptible range of the CLSI breakpoint (Ͻ2 g/ml), including those with oxacillin MICs of 1 g/ml (3.3%, 6/180), and especially in those with oxacillin MICs of 2 g/ml (57.1%, 52/91). Nearly all of these isolates belong to the prevalent C-MRSA clone, CC59:SCCmec V:pvl-positive, in Taiwan (5,14). Although the majority were from wound specimens, these isolates were from different years and adult and pediatric patients in more than 20 hospitals, indicating that they were not the result of an outbreak.…”

Section: Discussionmentioning

confidence: 99%

“…ST59, the founder of clonal complex 59 (CC59), is prevalent in Taiwan (5,14), and comprises two types: the predominant one carries SCCmec type V and is pvl positive, while the pvl-negative ST59 strains mostly carry SCCmec type IV (1,5,14). In addition to being the dominant C-MRSA in Taiwan, the CC59:SCCmec V clone has also been a significant cause of hospital-acquired bloodstream infections in a large medical center in Taiwan (4).…”

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confidence: 99%

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mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

et al. 2012

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Although the presence of mecA is the genotypic determinant of methicillin-resistant Staphylococcus aureus (MRSA), certain MRSA strains, especially community-associated MRSA (C-MRSA), can display an oxacillin MIC in the Clinical and Laboratory Standards Institute susceptible breakpoint range (<2 g/ml). Among 91 and 180 isolates thought to be methicillin-susceptible S. aureus (MSSA) with oxacillin MICs of 2 and 1 g/ml as determined by the Sensititre broth microdilution test initially, 52 (57.1%) and 6 (3.3%), respectively, were mecA positive. These mecA-positive low-oxacillin-MIC isolates belong to the dominant Taiwan C-MRSA clone (clonal complex [CC] 59), 56 of which carried SCCmec type V and were pvl positive, and 43 of which belonged to spa CC t437. All 271 isolates were retested by Sensititre, as well as by Vitek II and disk diffusion (DD). Based on the oxacillin results, the sensitivities of the Sensititre, Vitek II, and DD methods were 48.3% (28/58), 46.6% (27/58), and 89.6% (52/ 58), respectively. Although cefoxitin was better at detecting these isolates, 12.1, 10.4, and 5.2% of these isolates were still misidentified as MSSA by Sensititre, Vitek II, and DD, respectively. These results highlight the difficulty in the accurate identification of MRSA with borderline oxacillin MICs in the CC59:SCCmec V clone, which likely has contributed to its spread in the health care and community settings. Since this clone has now been detected in other countries, and since other C-MRSA lineages have also been found to have low-level ␤-lactam resistance, the findings of the present study may be relevant to other regions. Further studies are warranted to determine the extent and clinical impact of such misidentification.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

mecA -Positive Staphylococcus aureus with Low-Level Oxacillin MIC in Taiwan

et al. 2012

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“…In Taiwan, the majority of MRSA strains belong to four clones, sequence type 239-staphylococcal cassette chromosome mec type III (ST239-SCCmec III), ST5-SCCmec II, pvlnegative ST59-SCCmec IV, and pvl-positive ST59-SCCmec V (3,8,9,14). The predominant CA-MRSA clones in different regions have diverse genetic backgrounds, such as ST8 (USA300) in the United States, ST80 and ST45 in Europe, and ST30 in Asia (4,5,12,13), but most carry SCCmec IV, while ST59-SCCmec V ("Taiwan clone") predominates in Taiwan (3,8). We here report the complete genome of M013, a pvl-positive, ST59-SCCmec V MRSA strain isolated in 2002 from a wound specimen of a pediatric outpatient during part of the Taiwan Surveillance of Antimicrobial Resistance surveillance (TSAR) project (2,11).…”

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confidence: 99%

Complete Genome Sequence of Staphylococcus aureus M013, a pvl-Positive, ST59-SCCmec Type V Strain Isolated in Taiwan

Huang

Chen

Miu

et al. 2012

Journal of Bacteriology

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We report the complete genome sequence of M013, a representative strain of a pvl-positive, sequence type 59-staphylococcal cassette chromosome mec type V (ST59-SCCmec type V) community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone in Taiwan. Comparison of M013 with the genomes of two CA-MRSA strains in the United States revealed major differences in the regions covering several genomic islands and prophages.

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“…Chambers (2005) reported that PVL is the primary virulence factor responsible for the epidemic caused by CA-MRSA strains (38). However, more than 80 of CA-MRSA ST59 clones detected in Taiwan were SCCmec VT-pvl-positive and SCCmec IV-pvl-negative (39), and most ST59 clones in Hong Kong were SCCmec IV-pvl-positive (9). The majority of ST59 clones isolated from Wuhan were SCCmec IV-pvl-positive, while the remaining isolates were SCCmec V-pvl-positive (36).…”

Section: Discussionmentioning

confidence: 99%