Predominant Dissemination of PVL-Negative CC89 MRSA with SCC<i>mec</i>Type II in Children with Impetigo in Japan

Kikuta, Hídeaki; Shibata, Mutsuo; Nakata, Satoshi; Yamanaka, Takeshi; Sakata, Hiroshi; Akizawa, Koji; Kobayashi, Kiyoko

doi:10.1155/2011/143872

Cited by 27 publications

(18 citation statements)

References 41 publications

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“…The ST121 clone is rarely dominant in MRSA clinical infections. It has been reported that 11.8% of MRSA strains belonged to ST121 in Cambodia, 24 7.1% in Japan, 25 5.4% in Portugal 26 and 0.3% in Spain. 27 The important finding from the present study is that ST121 (35.3%), which had been previously documented in only two isolates (3.5%) among MRSA causing SSTIs in 2015, 28 was more prevalent than ST59 (25.5%).…”

Section: Discussionmentioning

confidence: 99%

Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China

Liu

Yang

et al. 2016

Emerging Microbes & Infections

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We evaluated the epidemiological and molecular features of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and methicillin-sensitive S. aureus (MSSA) from children and adult patients with skin and soft-tissue infections (SSTIs) in China. Prospective community-acquired S. aureus SSTI surveillance was conducted in 23 hospitals over a 24-month period. Susceptibility to 16 antimicrobials was evaluated using the agar dilution method. StatApriori was used to determine statistically significant association trends. The genotypic characteristics of CA-MRSA isolates were tested by staphylococcal cassette chromosome mec (SCCmec) typing, staphylococcal protein A (spa) typing, and multilocus sequence typing. The presence of Panton–Valentine leukocidin (pvl) genes was determined. Overall, 71.6% (1946/2716) of cases were community-associated S. aureus. CA-MRSA accounted for 2.6% (51). Out of 1895 methicillin-sensitive S. aureus strains, 97.3% were resistant to erythromycin, 96.6% to penicillin and 89.1% to clindamycin. No S. aureus strains were resistant to vancomycin. Thirteen sequence types (STs) and 17 spa types were detected among the CA-MRSA strains. The most prevalent sequence type was ST121 (19/51, 37.3%), followed by ST59 (13/51, 25.5%). In addition, t437 was predominant, accounting for 43.1% (22/51). Only five (9.8%) of the CA-MRSA strains harbored pvl genes. There were no significant differences in antibiotic sensitivity profiles between ST121 and non-ST121 MRSA isolates. However, ST121 strains tended to be more resistant to cefazolin, whereas non-ST121 strains were more resistant to chloramphenicol. In conclusion, CA-MRSA infections are rare among Chinese SSTI patients. MRSA strains in China have diverse genetic backgrounds, with ST121 being the predominant clone. Fusidic acid and mupirocin remain effective for topical treatment.

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Section: Discussionmentioning

confidence: 99%

Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China

Liu

Yang

et al. 2016

Emerging Microbes & Infections

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“…S. aureus strains ATCC 49775 (PVL positive, agrIII), Fri913 (tst positive, fnbA positive, agrI), A920211 (eta/etb positive, mupA positive), Fri137 (agrII), and HT 20000195 (agrIV), as well as Staphylococcus epidermidis strain ATCC 12228 (ACME positive), were used as positive controls for PCRs (27). The primers used and the PCR conditions were described in previous publications (3,(28)(29)(30).…”

Section: Methodsmentioning

confidence: 99%

Emergence of a Staphylococcus aureus Clone Resistant to Mupirocin and Fusidic Acid Carrying Exotoxin Genes and Causing Mainly Skin Infections

et al. 2017

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Skin and soft tissue infections (SSTIs) caused by mupirocin-resistant Staphylococcus aureus strains have recently increased in number in our settings. We sought to evaluate the characteristics of these cases over a 43-month period. Data for all community-acquired staphylococcal infections caused by mupirocin-resistant strains were retrospectively reviewed. Genes encoding products producing high-level resistance (HLR) to mupirocin (mupA), fusidic acid resistance (fusB), resistance to macrolides and lincosamides (ermC and ermA), Panton-Valentine leukocidin (PVL) (lukS/lukF-PV), exfoliative toxins (eta and etb), and fibronectin binding protein A (fnbA) were investigated by PCRs in 102 selected preserved strains. Genotyping was performed by SCCmec and agr typing, whereas clonality was determined by pulsedfield gel electrophoresis (PFGE) and multilocus sequence typing (MLST). A total of 437 cases among 2,137 staphylococcal infections were recorded in 2013 to 2016; they were all SSTIs with the exception of 1 case of primary bacteremia. Impetigo was the predominant clinical entity (371 cases [84.9%]), followed by staphylococcal scalded skin syndrome (21 cases [4.8%]), and there were no abscesses. The number of infections detected annually increased during the study years. All except 3 isolates were methicillin susceptible. The rates of HLR to mupirocin and constitutive resistance to clindamycin were 99% and 20.1%, respectively. Among the 102 tested strains, 100 (98%) were mupA positive and 97 (95%) were fusB positive, 26/27 clindamycin-resistant strains (96.3%) were ermA positive, 83 strains (81.4%) were lukS/lukF positive, 95 (93%) carried both eta and etb genes, and 99 (97%) were fnbA positive. Genotyping of methicillin-sensitive S. aureus (MSSA) strains revealed that 96/99 (96.7%) belonged to one main pulsotype, pulsotype 1, classified as sequence type 121 (ST121). The emergence of a single MSSA clone (ST121) causing impetigo was documented. Resistance to topical antimicrobials and a rich toxinogenic profile confer to this clone adaptability for spread in the community.

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“…Of these 5 minor clones, 3 strains (ST121/SCCmecV, ST59/ SCCmecIVa, and ST5/SCCmecIVc) are known to be rare in Japan. To the best of our knowledge, the ST121 clone has mainly been reported as a PVL-positive methicillin-susceptible S. aureus clone (21-23), while there have been only a few reports of ST121 MRSA clones isolated in Japan, China, and Cambodia (24,25). In addition, to our knowledge, we report the first detection of the ST81/SCCmecIVg strain in Japan.…”

Section: Discussionmentioning

confidence: 81%

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Isolated from Children in a Community with Low Antimicrobial Pressure in Japan

et al. 2012

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Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmecType II in Children with Impetigo in Japan

Cited by 27 publications

References 41 publications

Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China

Characterization of community-associated Staphylococcus aureus from skin and soft-tissue infections: a multicenter study in China

Emergence of a Staphylococcus aureus Clone Resistant to Mupirocin and Fusidic Acid Carrying Exotoxin Genes and Causing Mainly Skin Infections

Molecular Epidemiology of Methicillin-Resistant Staphylococcus aureus Isolated from Children in a Community with Low Antimicrobial Pressure in Japan

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