Epidemiological Typing of Community-Acquired Methicillin-Resistant Staphylococcus aureus Isolates from Children in Taiwan

Wang, Chih Chien; Lo, Wen Tsung; Chu, Mong Ling; Siu, L. Kristopher

doi:10.1086/422642

Cited by 114 publications

(86 citation statements)

References 39 publications

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“…Consistent with our previous results obtained by disk diffusion (42), 100% of the SSTI isolates were resistant to ERY and CLI (Table 2). Of the 34 colonization isolates from patients lacking risk factors, 94.1 and 91.2% were resistant to ERY and CLI, respectively ( Table 2).…”

Section: Resultssupporting

confidence: 92%

“…Two groups of CAMRSA isolates from Taipei were studied. The first group, TSGH 1 to 17, were consecutive CAMRSA isolates from children hospitalized at TSGH for SSTIs during the 5-year period from September 1997 to August 2002 (42). A case was considered community acquired if the isolate was obtained from a patient within 72 h of admission to TSGH.…”

Section: Methodsmentioning

confidence: 99%

“…We previously analyzed 17 CAMRSA isolates obtained from patients with SSTIs from the Tri-Services General Hospital (TSGH), a tertiary care, military medical school-affiliated institution in Taipei, for antimicrobial susceptibility patterns, genotyping by MLST and SmaI genomic fingerprinting, the presence of the PVL locus (42), and the SCCmec type. The resistance phenotypes differed from CAMRSA described from other locations in that the isolates uniformly had the constitutive macrolide, lincosamide, and streptogramin B resistance (MLS Bc ) phenotype.…”

mentioning

confidence: 99%

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Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV

et al. 2005

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Methicillin-resistant Staphylococcus aureus (MRSA) isolates carry the methicillin resistance gene (mecA) on a horizontally transferred genetic element called the staphylococcal chromosome cassette mec (SCCmec). Community-acquired MRSA (CAMRSA) isolates usually carry SCCmec type IV. We previously reported that 76% of 17 CAMRSA isolates (multilocus sequence type 59) obtained from pediatric patients with skin and soft tissue infections (SSTI) from Taipei did not carry SCCmec types I to IV. We used DNA sequence analysis to determine that the element harbored by these nontypeable isolates is a novel subtype of SCCmec V called SCCmec V T. It contains a ccrC recombinase gene variant (ccrC2) and mec complex C2. One SSTI isolate contained molecular features of SCCmec IV but also contained ccrC2 (a feature of SCCmec V T ), suggesting that it may harbor a composite SCCmec element. The genes lukS-PV and lukF-PV encoding the Panton-Valentine leukocidin (PVL) were present in all CAMRSA SSTI isolates whether they contained SCCmec type IV or V T . SCCmec V T was also present in 5 of 34 (14.7%) CAMRSA colonization isolates collected from healthy children from Taipei who lacked MRSA risk factors. Four (80%) of the these isolates contained lukS-PV and lukF-PV, as did 1 of 27 (3.7%) SCCmec IV-containing colonization isolates. A total of 63% (10 of 16) of the SSTI isolates and 61.7% (21 of 34) of the colonization isolates tested were resistant to at least four classes of non-␤-lactam antimicrobials. SCCmec V T is a novel SCCmec variant that is found in multiply resistant CAMRSA strains with sequence type 59 in Taipei in association with the PVL leukotoxin genes.

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Section: Resultssupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV

et al. 2005

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“…As in this study, SCCmec IIb, first described in Japanese CA-MRSA isolates, also carries etb (45). There was no pvl gene found in CA-MRSA isolates from South Korea or Japan (14,26,30,32,39), while the pvl gene was present in those from Taiwan (44). Combined with the findings that eta was confined to agr-4 MSSA and tst was found in MRSA or MSSA isolates of the agr-1 or agr-3 type, these toxin genes indicate the evolution and spread of certain S. aureus strains.…”

Section: Discussionsupporting

confidence: 62%

Epidemiological Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates from Children with Eczematous Atopic Dermatitis Lesions

Chung¹,

Jeon²,

Sung³

et al. 2008

J Clin Microbiol

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In this study, we investigated the rate of colonization of skin of children with atopic dermatitis (AD) by methicillin-resistant Staphylococcus aureus (MRSA) and characterized the isolates. Active skin lesions in pediatric AD patients were cultured with Rodac Staph (Komed, Korea). S. aureus isolates were examined for drug susceptibilities, analyzed for the eta, etb, tst, and pvl genes, and typed using agr polymorphism, pulsed-field gel electrophoresis of SmaI-restricted chromosomal DNA, and staphylococcal cassette chromosome mec (SCCmec) typing. Eighty-seven (75.4%) of 115 patients had cultivable S. aureus isolates, 16 of which (18.3%) were MRSA. All MRSA isolates were susceptible to chloramphenicol, rifampin, cotrimoxazole, and ciprofloxacin. While methicillin-susceptible S. aureus (MSSA) isolates were composed of 23 isolates of singular types and nine clusters comprising 48 isolates, MRSA isolates were typed into three clones: eight isolates of pulsotype A-agr-1-SCCmec IV, five isolates of pulsotype B-agr-3-SCCmec IIb-etb positive, and three isolates of pulsotype C-agr-3-SCCmec IV. Three SCCmec IVA MRSA isolates were tst positive, but none were positive for the pvl or eta gene. Among 71 MSSA isolates, 7 isolates were tst positive, 6 of which were pulsotype F-agr-3, and 9 of 10 agr-4 isolates were eta positive. The average ages of patients carrying MSSA, SCCmec IVA MRSA, and SCCmec IIb MRSA were 7.7 ؎ 4.6, 3.1 ؎ 1.5, and 8.2 ؎ 3.1 years, respectively. Among the patients carrying MRSA, two patients had been treated with oral antimicrobials, and one had been admitted to the hospital 18 months previously. In conclusion, community-acquired MRSA isolates of a few clones colonized the skin of patients with AD without risk factors for the acquisition of hospital-acquired MRSA, which suggested that the skin of children with AD may represent a significant reservoir of MRSA colonization in the community.

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“…In Taiwan, CA-MRSA isolates are also resistant to multiple antimicrobial agents; 71.4%, 91.4%, and 41.2% are resistant to clindamycin, erythromycin, and chloramphenicol, respectively (4). Trimethoprim/sulfamethoxazole is more effective against CA-MRSA isolates than other first-line antimicrobial agents: the resistance rate is 0%-65.7% (4,5 In response: Dr Ma makes an excellent point about the limitations of study data on antimicrobial drug treatment of skin abscesses (1). All of the patients described in our study (2) required antimicrobial drug therapy, and most were admitted to the hospital.…”

Section: Staphylococcus Aureus Skin Infectionsmentioning

confidence: 99%

Methicillin-resistantStaphylococcus aureusSkin Infections

Moran

Amii

Abrahamian

et al. 2005

Emerg. Infect. Dis.

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Epidemiological Typing of Community-Acquired Methicillin-Resistant Staphylococcus aureus Isolates from Children in Taiwan

Cited by 114 publications

References 39 publications

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV

Epidemiological Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates from Children with Eczematous Atopic Dermatitis Lesions

Methicillin-resistantStaphylococcus aureusSkin Infections

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Epidemiological Typing of Community-Acquired Methicillin-Resistant Staphylococcus aureus Isolates from Children in Taiwan

Cited by 114 publications

References 39 publications

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V T or SCC mec Type IV

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V T or SCC mec Type IV

Epidemiological Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates from Children with Eczematous Atopic Dermatitis Lesions

Methicillin-resistantStaphylococcus aureusSkin Infections

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Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCC mec ) Type V _T or SCC mec Type IV