title: Panton-Valentine leukocidin (PVL)-positive health care-associated methicillin-resistant Staphylococcus aureus isolates are associated with skin and soft tissue infections and colonized mainly by infective PVL-encoding bacteriophages.
abstract: The emergence of Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) is a public health concern worldwide. PVL is associated with community-associated MRSA and is linked to skin and soft tissue infections (SSTIs). However, PVL genes have also been detected in health care-associated (HA) MRSA isolates. The diseases associated with PVL-positive HA-MRSA isolates and the distributions of PVL-encoding bacteriophages in HA-MRSA have not been determined. In this study, a total of 259 HA-MRSA strains isolated between 2009 and 2012 in China from inpatients with SSTIs, pneumonia, and bacteremia were selected for molecular typing, including staphylococcal cassette chromosome mec typing, multilocus sequence typing, and staphylococcal protein A gene typing. The PVL genes and PVL bacteriophages in the MRSA isolates were characterized by PCR. Among the tested MRSA isolates, 28.6% (74/259) were PVL positive. The high prevalence of PVL-carrying HA-MRSA was observed to be associated with SSTIs but not with pneumonia or bacteremia. The PVL-positive HA-MRSA isolates were colonized mainly by infective PVL phages, namely, Φ7247PVL, ΦSLT, and ΦSa2958. The distribution of PVL-carrying bacteriophages differed geographically. Our study highlights the potential risk of the emergence of multidrug-resistant HA-MRSA strains with increased virulence.
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Qiwen
authors.initials: Q
authors.lastname: Hu
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi, China.
authors.forename: Wenchang
authors.initials: W
authors.lastname: Yuan
authors.affiliation: Department of Laboratory Medicine, Nanfang Hospital, Guangzhou, China.
authors.forename: Fangyin
authors.initials: F
authors.lastname: Zeng
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Weilong
authors.initials: W
authors.lastname: Shang
authors.affiliation: Department of Laboratory Medicine, 411 Hospital, Shanghai, China.
authors.forename: Dahai
authors.initials: D
authors.lastname: Tang
authors.affiliation: Department of Laboratory Medicine, Liao Ning North Hospital, Shenyang, China.
authors.forename: Wencheng
authors.initials: W
authors.lastname: Xue
authors.affiliation: Clinical Laboratory Diagnostic Center, Urumqi General Hospital of PLA, Urumqi, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Fu
authors.affiliation: Department of Emergency, Xinqiao Hospital, Chongqing, China.
authors.forename: Renjie
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Junmin
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Jizhen
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Rao
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Zhijin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Fourth Military Medical University, Xian, China.
authors.forename: Xingan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Microbiology, College of Basic Medical Sciences, Third Military Medical University, Chongqing, China raoxiancai@126.com.
authors.forename: Xiancai
authors.initials: X
authors.lastname: Rao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001427:Bacterial Toxins / Q000235:genetics*; D002681:China; D003428:Cross Infection; D005098:Exotoxins / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics* / Q000821:virology*; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000382:microbiology*; D018461:Soft Tissue Infections / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000382:microbiology*; D013204:Staphylococcus Phages / Q000235:genetics*
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin