title: Molecular epidemiologic study of community-associated methicillin-resistant Staphylococcus aureus with Panton-Valentine leukocidin gene among family members in Japan.
abstract: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is one of the worldwide concerns of antimicrobial chemotherapy. An accumulation of ten patients in five families (A-E) suffering from skin and soft tissue infection (SSTI) of CA-MRSA was experienced in 2012, in Fuchu-shi, Tokyo, Japan. Molecular epidemiological investigation was performed for the 10 MRSA strains obtained from 8 children and 2 of their parents to assess endemic patterns of CA-MRSA in the community. Results of molecular typing, presence of toxin genes and antimicrobial susceptibilities were analyzed combined with the patients' clinical information. Each family had its own unique MRSA strain: A, ST30-SCCmec IVd; B, ST8-SCCmec IVd; C, ST8-SCCmec IVa; D, ST8-SCCmec IVl; E, ST8-SCCmec IVl and ST858-SCCmec IVl. Seven strains from the families A-C carried Panton-Valentine leukocidin gene. Three strains from the families D and E carried toxic shock syndrome toxin gene. Strains belonged to the same family demonstrated genetically related banding patterns of pulsed-filed gel electrophoresis. The family C experienced intrafamilial transmission of USA300-0114. Our data showed the MRSA clones disseminating in this community were highly diverse. They contained USA300-0114 clone, the rapidly distributing clone in the world, as well as MRSA clones identified in Japan. Our results suggested intrafamilial transmission of MRSA could be initial phenomenon of wide transmission in a community, therefore CA-MRSA SSTI in children and their family members should be monitored closely in order to notice the spread of highly pathogenic and transmittable strains.
authors.affiliation: Department of Infection Control Science, Juntendo University, Faculty of Medicine, Japan. Electronic address: yuuehara@juntendo.ac.jp.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: Department of Infection Control Science, Juntendo University, Faculty of Medicine, Japan.
authors.forename: Teruyo
authors.initials: T
authors.lastname: Ito
authors.affiliation: Department of Infection Control Science, Juntendo University, Faculty of Medicine, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hirotaki
authors.affiliation: Department of Infectious Diseases, Shizuoka Children's Hospital, Japan.
authors.forename: Takayo
authors.initials: T
authors.lastname: Shoji
authors.affiliation: Division of Clinical Laboratory, Tokyo Metropolitan Children's Medical Center, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Tame
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center, Japan.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Horikoshi
authors.affiliation: Department of Infection Control Science, Juntendo University, Faculty of Medicine, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hiramatsu
mesh_terms: D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D004768:Enterotoxins / Q000235:genetics; D005098:Exotoxins / Q000235:genetics*; D005260:Female; D006801:Humans; D007169:Impetigo / Q000453:epidemiology* / Q000382:microbiology; D007564:Japan / Q000453:epidemiology; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D058889:Molecular Typing; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D018089:Superantigens / Q000235:genetics
chemical_list: D001427:Bacterial Toxins; D004768:Enterotoxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D018089:Superantigens; C030107:enterotoxin F, Staphylococcal
keywords: Community-associated methicillin-resistant Staphylococcus aureus; Intrafamilial transmission; Panton-Valentine leukocidin; Skin and soft tissue infection; USA300