title: Unusually high prevalence of panton-valentine leukocidin genes among methicillin-sensitive Staphylococcus aureus strains carried in the Indonesian population.
abstract: Few data on the molecular characteristics and epidemiology of Staphylococcus aureus from Indonesia are available. The purpose of the present study was to define S. aureus reservoirs in both the Indonesian community and hospital using a collection of 329 nasal carriage isolates obtained during a survey of 3,995 healthy individuals and patients from Java, Indonesia. Only one strain (0.3%) was identified as methicillin-resistant S. aureus by mecA gene PCR. The Panton-Valentine leukocidin (PVL) genes were detected in 35 methicillin-sensitive S. aureus strains (10.6%). Molecular typing by pulsed-field gel electrophoresis of the 329 isolates showed extensive genetic diversity among both PVL-positive and PVL-negative strains. In Surabaya, Indonesia, however, a cluster was identified that was strongly associated with the presence of the PVL locus (P < 0.0001). As determined by high-throughput amplified fragment length polymorphism, PVL-positive strains occurred throughout all major AFLP clusters (I to IV). Multilocus sequence typing of a subset of isolates showed that most PVL-positive strains belonged to sequence type (ST) 188, while most PVL-negative isolates belonged to ST45. The high prevalence of PVL-positive S. aureus strains in certain regions of Indonesia is of concern since these strains may cause severe infections in the community and in hospitals.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, Rotterdam, The Netherlands. j.severin@erasmusmc.nl
authors.forename: Juliëtte A
authors.initials: JA
authors.lastname: Severin
authors.forename: Endang Sri
authors.initials: ES
authors.lastname: Lestari
authors.forename: Kuntaman
authors.initials: K
authors.lastname: Kuntaman
authors.forename: Damian C
authors.initials: DC
authors.lastname: Melles
authors.forename: Martijn
authors.initials: M
authors.lastname: Pastink
authors.forename: Justine K
authors.initials: JK
authors.lastname: Peeters
authors.forename: Susan V
authors.initials: SV
authors.lastname: Snijders
authors.forename: Usman
authors.initials: U
authors.lastname: Hadi
authors.forename: D Offra
authors.initials: DO
authors.lastname: Duerink
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001427:Bacterial Toxins / Q000235:genetics*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D016521:Electrophoresis, Gel, Pulsed-Field; D005098:Exotoxins / Q000235:genetics*; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007956:Leukocidins / Q000235:genetics*; D008712:Methicillin / Q000494:pharmacology*; D017720:Molecular Epidemiology; D009296:Nasal Cavity / Q000382:microbiology*; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D008712:Methicillin