Community-acquired, methicillin-resistant Staphylococcus aureus isolated from children with community-onset pneumonia in China.
Community-acquired, methicillin-resistant Staphylococcus aureus (CA-MRSA) has been associated with morbidity and mortality in various countries. In this study, we characterized the molecular and clinical features of pediatric CA-MRSA pneumonia in China. Between June 2006 and February 2008, 55 previously healthy children confined in eight hospitals countrywide were found to be afflicted with CA-MRSA pneumonia. A total of 55 strains collected from these children were analyzed by multilocus sequence typing (MLST), Staphylococcus cassette chromosome mec (SCCmec) typing, and spa typing. The Panton-Valentine leukocidin (PVL) gene was also detected. Overall, nine STs were obtained, with ST59 (40.4%) established to be the most prevalent type. We first registered the new ST1409 from a child with necrotizing pneumonia. SCCmecIVa was the most predominant type, followed by SCCmec type V. Twelve spa types were identified, of which one new spa type, t5348, was first detected and registered. One typical livestock-associated spa type, t034, was found in a 4-month-old girl living in the countryside. We also found that 40% of those isolates were PVL-positive. In addition, the median age of the children in this study was 10 months. A total of 69% (38/55) of the children with community-acquired pneumonia (CAP) had preceding influenza or influenza-like illness, and three ST910-MRSA-IV strains (PVL gene-positive) were associated with severe necrosis. The results indicated that the recent CA-MRSA found in Chinese children with CAP was largely associated with the spread of the ST59-MRSA-IV clone, and most of the PVL-positive strains in this study did not cause necrotic cases.
Beijing Children's Hospital Affiliated with Capital Medical University, Beijing, China.
Wenjing
W
Geng
Yonghong
Y
Yang
Dejing
D
Wu
Wenshuang
W
Zhang
Chuanqing
C
Wang
Yunxiao
Y
Shang
Yuejie
Y
Zheng
Li
L
Deng
Zhou
Z
Fu
Xiangyang
X
Li
Sangjie
S
Yu
Xuzhuang
X
Shen
D000293:Adolescent; D001427:Bacterial Toxins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D005098:Exotoxins / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007956:Leukocidins / Q000235:genetics; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D011023:Pneumonia, Staphylococcal / Q000453:epidemiology* / Q000382:microbiology*; D011159:Population Surveillance; D015995:Prevalence; D011446:Prospective Studies
D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin