title: Community-acquired methicillin-resistant Staphylococcus aureus in Madrid, Spain: transcontinental importation and polyclonal emergence of Panton-Valentine leukocidin-positive isolates.
abstract: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) isolates producing the Panton-Valentine leukocidin (PVL) have been reported worldwide. We describe the molecular characteristics of PVL-positive CA-MRSA strains isolated in Madrid, Spain, and analyze the clinical features of patients infected with these isolates. From 2004 to 2007, we collected 13 PVL-positive MRSA isolates from patients attending to the emergency department. The isolates were genotyped by pulsed-field gel electrophoresis, SCCmec typing, agr polymorphism, and multilocus sequence typing. Susceptibility to 29 antimicrobials was determined by the broth microdilution and by the E-test methods. The isolates belonged to 3 genotypes: ST8-SCCmec IVc (n = 11), ST5-SCCmec IVa (n = 1), and ST80-SCCmec IVc (n = 1). The corresponding agr types were I, II, and III, respectively. Five isolates were resistant to tetracycline and doxycycline, and 1 was resistant to fusidic acid (ST80). The isolates were from children (n = 9) and adults (n = 4), and were associated with skin and soft tissue infections (n = 9), otitis (n = 1), and bacteremia (n = 1). Nine patients were from South America. Our results indicate the transcontinental importation and recent emergence in Spain of PVL-positive CA-MRSA strains belonging to 3 distinct lineages, including 1 predominant (ST8-SCCmec IVc).
authors.affiliation: Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain. ecercenado@terra.es
authors.forename: Emilia
authors.initials: E
authors.lastname: Cercenado
authors.forename: Oscar
authors.initials: O
authors.lastname: Cuevas
authors.forename: Mercedes
authors.initials: M
authors.lastname: Marín
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
authors.forename: Pilar
authors.initials: P
authors.lastname: Trincado
authors.forename: Teresa
authors.initials: T
authors.lastname: Boquete
authors.forename: Belén
authors.initials: B
authors.lastname: Padilla
authors.forename: Ana
authors.initials: A
authors.lastname: Vindel
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000382:microbiology; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000096:biosynthesis*; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins / Q000096:biosynthesis*; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007956:Leukocidins / Q000096:biosynthesis*; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D010031:Otitis / Q000382:microbiology; D017422:Sequence Analysis, DNA; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D015534:Trans-Activators / Q000235:genetics
chemical_list: C095698:Agr protein, Staphylococcus aureus; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D015534:Trans-Activators