Characterization of community acquired Staphylococcus aureus associated with skin and soft tissue infection in Beijing: high prevalence of PVL+ ST398.
Adult community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and methicillin-susceptible S. aureus (CA-MSSA) skin and soft tissue infection (SSTI) in China is not well described. A prospective cohort of adults with SSTI was established between January 2009 and August 2010 at 4 hospitals in Beijing. Susceptibility testing and molecular typing, including multilocus sequence typing, spa, agr typing, and toxin detection were assessed for all S. aureus isolates. Overall, 501 SSTI patients were enrolled. Cutaneous abscess (40.7%) was the most common infection, followed by impetigo (6.8%) and cellulitis (4.8%). S. aureus accounted for 32.7% (164/501) of SSTIs. Five isolates (5/164, 3.0%) were CA-MRSA. The most dominant ST in CA-MSSA was ST398 (17.6%). The prevalence of Panton-Valentine Leukocidin (pvl) gene was 41.5% (66/159) in MSSA. Female, younger patients and infections requiring incision or drainage were more commonly associated with pvl-positive S. aureus (P<0.03); sec gene was more often identified in CC5 (P<0.03); seh gene was more prevalent in CC1 (P = 0.001). Importantly, ST59 isolates showed more resistance to erythromycin, clindamycin and tetracycline, and needed more surgical intervention. In conclusion, CA-MRSA infections were rare among adult SSTI patients in Beijing. Six major MSSA clones were identified and associated with unique antimicrobial susceptibility, toxin profiles, and agr types. A high prevalence of livestock ST398 clone (17.1% of all S. aureus infections) was found with no apparent association to animal contact.
Department of Clinical Laboratory, Peking University People's Hospital, Peking University, Beijing, China.
Chunjiang
C
Zhao
Yingmei
Y
Liu
Mingze
M
Zhao
Yali
Y
Liu
Yong
Y
Yu
Hongbin
H
Chen
Qiuning
Q
Sun
Huawei
H
Chen
Wei
W
Jiang
Yudong
Y
Liu
Shaomei
S
Han
Yingchun
Y
Xu
Minjun
M
Chen
Bin
B
Cao
Hui
H
Wang
D001427:Bacterial Toxins / Q000235:genetics; D002681:China / Q000453:epidemiology; D002947:Cities; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000235:genetics; D005098:Exotoxins / Q000235:genetics; D006801:Humans; D007956:Leukocidins / Q000235:genetics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*; D058885:Multilocus Sequence Typing; D015995:Prevalence; D011446:Prospective Studies; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology*; D013045:Species Specificity; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000235:genetics
D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin