title: Recurrent furunculosis caused by a community-acquired Staphylococcus aureus strain belonging to the USA300 clone.
abstract: BACKGROUND
  A 24-year-old female with recurrent skin and soft tissue infections (SSTI) was enrolled as part of a multicenter observational cohort study conducted by a practice-based research network (PBRN) on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).
  
  
  METHODS
  Strains were characterized by pulsed-field gel electrophoresis (PFGE), spa typing, and multilocus sequence typing. MRSA strains were analyzed for SCCmec type and the presence of the Panton-Valentine leukocidin (PVL) and arginine catabolic mobile element (ACME) using PCR.
  
  
  RESULTS
  In the first episode, S. aureus was recovered from the wound and inguinal folds; in the second, S. aureus was recovered from a lower abdomen furuncle, inguinal folds, and patellar fold. Molecular typing identified CA-MRSA clone USA300 in all samples as spa-type t008, ST8, SCCmecIVa, and a typical PFGE pattern. The strain carried virulence genes pvl and ACME type I. Five SSTI episodes were documented despite successful resolution by antibiotic treatment, with and without incision and drainage.
  
  
  CONCLUSIONS
  The source of the USA300 strain remains unknown. The isolate may represent a persistent strain capable of surviving extensive antibiotic pressure or a persistent environmental reservoir may be the source, possibly in the patient's household, from which bacteria were repeatedly introduced into the skin flora with subsequent infections.
authors: 1 Urban Health Plan , Bronx, New York.
authors: Shirish
authors: S
authors: Balachandra
authors: Maria
authors: M
authors: Pardos de la Gandara
authors: Scott
authors: S
authors: Salvato
authors: Tracie
authors: T
authors: Urban
authors: Claude
authors: C
authors: Parola
authors: Chamanara
authors: C
authors: Khalida
authors: Rhonda G
authors: RG
authors: Kost
authors: Teresa H
authors: TH
authors: Evering
authors: Mina
authors: M
authors: Pastagia
authors: Brianna M
authors: BM
authors: D'Orazio
authors: Alexander
authors: A
authors: Tomasz
authors: Herminia
authors: H
authors: de Lencastre
authors: Jonathan N
authors: JN
authors: Tobin
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001427:Bacterial Toxins / Q000235:genetics; D015331:Cohort Studies; D005098:Exotoxins / Q000235:genetics; D005260:Female; D005667:Furunculosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D020071:Interspersed Repetitive Sequences / Q000235:genetics; D007956:Leukocidins / Q000235:genetics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000235:genetics*; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology; D014774:Virulence / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D037521:Virulence Factors