title: High diversity of Panton-Valentine leukocidin-positive, methicillin-susceptible isolates of Staphylococcus aureus and implications for the evolution of community-associated methicillin-resistant S. aureus.
abstract: In total, 100 Staphylococcus aureus isolates from diverse cases of skin and soft-tissue infection at a university hospital in Saxony, Germany, were characterised using diagnostic microarrays. Virulence factors, including Panton-Valentine leukocidin (PVL), were detected and the isolates were assigned to clonal groups. Thirty isolates were positive for the genes encoding PVL. Only three PVL-positive methicillin-resistant S. aureus (MRSA) isolates were found, two of which belonged to European clone ST80-MRSA IV and one to USA300 strain ST8-MRSA IV. The remaining methicillin-susceptible PVL-positive isolates belonged to a variety of different multilocus sequence types. The predominant strains were agrI/ST22, agrII/CC5, agrIII/CC30 and agrIV/ST121. In order to check for possible bias caused by regional or local outbreak strains, an additional 18 methicillin-susceptible, PVL-positive isolates from the UK were tested. Approximately two-thirds of the UK isolates belonged to types that also comprised approximately two-thirds of the isolates from Saxony. Some methicillin-susceptible PVL-positive isolates (agrI/ST152, agrIII/ST80 and agrIII/ST96) closely resembled known epidemic community-acquired MRSA (CaMRSA) strains. These findings indicate that the current rise in PVL-positive CaMRSA could be caused by the dissemination of novel SCCmec elements among pre-existing PVL-positive strains, rather than by the spread of PVL phages among MRSA strains.
authors.affiliation: Institute for Medical Microbiology and Hygiene, Faculty of Medicine Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. monecke@rocketmail.com
authors.forename: S
authors.initials: S
authors.lastname: Monecke
authors.forename: P
authors.initials: P
authors.lastname: Slickers
authors.forename: M J
authors.initials: MJ
authors.lastname: Ellington
authors.forename: A M
authors.initials: AM
authors.lastname: Kearns
authors.forename: R
authors.initials: R
authors.lastname: Ehricht
mesh_terms: D001427:Bacterial Toxins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D017714:Community-Acquired Infections / Q000382:microbiology*; D019143:Evolution, Molecular; D005098:Exotoxins / Q000235:genetics*; D022761:Gene Transfer, Horizontal; D014644:Genetic Variation; D005838:Genotype; D005858:Germany; D006801:Humans; D007956:Leukocidins / Q000235:genetics*; D016106:Methicillin Resistance / Q000235:genetics*; D046228:Microarray Analysis; D020411:Oligonucleotide Array Sequence Analysis; D013203:Staphylococcal Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D037521:Virulence Factors / Q000235:genetics
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D037521:Virulence Factors