title: The emerging ST8 methicillin-resistant Staphylococcus aureus clone in the community in Japan: associated infections, genetic diversity, and comparative genomics.
abstract: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a major concern worldwide. In the United States, ST8 CA-MRSA with SCCmecIVa (USA300) has been predominant, affecting the entire United States. In this study, we investigated Japanese ST8 CA-MRSA with new SCCmecIVl (designated ST8 CA-MRSA/J), which has emerged in Japan since 2003. Regarding community spread and infections, ST8 CA-MRSA/J spread in 16.2-34.4% as a major genotype in the community in Japan, and was associated with skin and soft tissue infections (SSTIs), colitis, and invasive infections (sepsis, epidural abscesses, and necrotizing pneumonia), including influenza prodrome cases and athlete infections, similar to USA300. It spread to even public transport and Hong Kong through a Japanese family. Regarding genetic diversity, ST8 CA-MRSA/J included ST and spa variants and was classified into at least three pulsed-field gel electrophoresis types, ST8 Jα to γ. Of those, ST8 Jβ was associated with severe invasive infections. As for genomics, ST8 CA-MRSA/J showed high similarities to USA300, but with marked diversity in accessory genes; e.g., ST8 CA-MRSA/J possessed enhanced cytolytic peptide genes of CA-MRSA, but lacked the Panton-Valentine leukocidin phage and arginine catabolic mobile element, unlike USA300. The unique features of ST8 CA-MRSA/J included a novel mosaic SaPI (designated SaPIj50) carrying the toxic shock syndrome toxin-1 gene with high expression; the evolution included salvage (through recombination) of hospital-acquired MRSA virulence. The data suggest that ST8 CA-MRSA/J has become a successful native clone in Japan, in association with not only SSTIs but also severe invasive infections (posing a threat), requiring attention.
authors.affiliation: Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Iwao
authors.forename: Rumiko
authors.initials: R
authors.lastname: Ishii
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tomita
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shibuya
authors.forename: Tomomi
authors.initials: T
authors.lastname: Takano
authors.forename: Wei-Chun
authors.initials: WC
authors.lastname: Hung
authors.forename: Wataru
authors.initials: W
authors.lastname: Higuchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Isobe
authors.forename: Akihito
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Mio
authors.initials: M
authors.lastname: Yano
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Kikuyo
authors.initials: K
authors.lastname: Ogata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okubo
authors.forename: Olga
authors.initials: O
authors.lastname: Khokhlova
authors.forename: Pak-Leung
authors.initials: PL
authors.lastname: Ho
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D021821:Communicable Diseases, Emerging / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D005260:Female; D014644:Genetic Variation; D023281:Genomics; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D018461:Soft Tissue Infections; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D037521:Virulence Factors