title: Methicillin-susceptible Staphylococcus aureus in skin and soft tissue infections, Northern Italy.
abstract: During February 2004-September 2006, familial clusters and sporadic cases of Staphylococcus aureus skin and soft tissue infections were observed in a suburban area near Milan in northern Italy. Molecular typing of the isolates showed an epidemic methicillin-susceptible S. aureus (MSSA) strain, spa type 005 and sequence type 22 that harbored Panton-Valentine leukocidin (PVL) genes. The first case-patients were neonates or mothers who had recently delivered in the local hospital. Examination of the medical records showed a cluster of postpartum mastitis and neonatal skin infections antedating the emergence of infections in the community. Nasal swabs of neonates, mothers, and hospital staff were positive for the epidemic MSSA. Hospital circulation of the strain was interrupted by implementation of infection control measures, although infections continued to occur in the community. The PVL-positive MSSA strain resembles typical community-acquired methicillin-resistant S. aureus in its ability to cause prolonged community and hospital outbreaks of skin infections.
authors.affiliation: Hospital of Lodi, Lodi, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tinelli
authors.forename: Monica
authors.initials: M
authors.lastname: Monaco
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vimercati
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceraminiello
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pantosti
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001427:Bacterial Toxins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D004196:Disease Outbreaks; D005098:Exotoxins / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D007956:Leukocidins / Q000235:genetics; D008297:Male; D008413:Mastitis / Q000453:epidemiology / Q000382:microbiology; D008712:Methicillin / Q000494:pharmacology*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D049590:Postpartum Period; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D008712:Methicillin