title: Clonal association of Staphylococcus aureus causing bullous impetigo and the emergence of new methicillin-resistant clonal groups in Kansai district in Japan.
abstract: A molecular epidemiological analysis was performed to reveal the clonal association of Staphylococcus aureus strains isolated from patients with bullous impetigo. Pulsed-field gel electrophoresis with cluster analysis, genetic and phenotypic characterizations, and antimicrobial susceptibility profiling of 88 S. aureus strains isolated from outpatients at 4 hospitals in the Kansai district in Japan were undertaken. Three distinct clonal groups were identified: 2 of them carried the exfoliative toxin (ET) A gene (eta), and the other carried the ETB gene (etb). The former groups represent 2 eta-positive clonal groups that have not been described previously. All the strains in the more dominant eta-positive clonal group and some of the strains in the etb-positive clonal group were methicillin-resistant S. aureus (MRSA) showing borderline-to-moderate resistance to beta-lactams. These MRSA strains appear to be emerging clonal groups that have not been considered in previous epidemiological studies of ET-producing S. aureus in Japan and thus pose a significant threat for future treatment of patients with bullous impetigo and/or staphylococcal scalded-skin syndrome.
authors: Department of Bacteriology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. dragons@hiroshima-u.ac.jp
authors: Takayuki
authors: T
authors: Yamaguchi
authors: Yoshiko
authors: Y
authors: Yokota
authors: Jun
authors: J
authors: Terajima
authors: Tetsuya
authors: T
authors: Hayashi
authors: Martin
authors: M
authors: Aepfelbacher
authors: Masaru
authors: M
authors: Ohara
authors: Hitoshi
authors: H
authors: Komatsuzawa
authors: Haruo
authors: H
authors: Watanabe
authors: Motoyuki
authors: M
authors: Sugai
mesh_terms: D001768:Blister / Q000453:epidemiology*; D004269:DNA, Bacterial / Q000235:genetics; D006761:Hospitals; D006801:Humans; D007169:Impetigo / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008712:Methicillin / Q000494:pharmacology; D016106:Methicillin Resistance / Q000235:genetics; D008826:Microbial Sensitivity Tests; D010045:Outpatients; D010406:Penicillins / Q000494:pharmacology; D012150:Polymorphism, Restriction Fragment Length; D013211:Staphylococcus aureus / Q000187:drug effects / Q000235:genetics*
chemical_list: D004269:DNA, Bacterial; D010406:Penicillins; D008712:Methicillin