Clinical manifestations and outcome of skin infections caused by the community-acquired methicillin-resistant Staphylococcus aureus clone ST80-IV.
BACKGROUND
Several Panton-Valentin leukocidin-positive clones of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are spreading worldwide. The European clone ST80-IV is the main CA-MRSA clone in Europe. There is no reported study of the specific clinical manifestations and outcome of skin infections caused by the clone ST80-IV, using strict definitions of skin diseases.


METHODS
Single-centre observational prospective cohort of S. aureus skin infections caused by the clone ST80-IV.


RESULTS
From November 1999 to October 2009, we diagnosed skin infections due to the clone ST80-IV in 20 patients (median age 28 years, median 27; range 1-66). All the isolates had all the following characteristics: lukPV, etd and edin gene-positive, agr 3 allele, spa-type t044 and ST80. All the isolates were resistant to beta-lactam agents, kanamycin, tetracycline and fusidic acid. During the study period, the 20 patients had the following manifestations: 19 primary abscesses (18 single abscess and one patient with two), eight furuncles, four folliculitis, one case of cellulitis, one wound infection and one felon. Surgical treatment and drainage was required for all the primary abscesses. The infections occurred mainly in the perineal area (50%). No secondary infections occurred in family members. Despite strict hygiene measures, systemic antibiotics and nasal mupirocine, four patients (20%) had recurrent skin infections over a period of a few months to 6 years.


CONCLUSIONS
The CA-MRSA clone ST80-IV is responsible for suppurative skin infections such as furuncles and abscesses, which can recur over a period of several years.
Del Giudice
P
P
Unité d'Infectiologie-Dermatologie, Hôpital Bonnet, Fréjus Université Lyon 1, Centre National de Référence des Staphylocoques, Lyon, France. del-giudice-p@chi-frejus-saint-raphael.fr
Bes
M
M
Hubiche
T
T
Roudière
L
L
Blanc
V
V
Lina
G
G
Vandenesch
F
F
Etienne
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000628:therapy*; D062109:Dermatologic Surgical Procedures; D004322:Drainage; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012867:Skin / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents