title: Antimicrobial susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility.
abstract: Methicillin-resistant Staphylococcus aureus (MRSA) is prevalent in Japan, and the Staphylococcus cassette chromosome mec (SCCmec) type II is common among hospital-acquired MRSA isolates. Information pertaining to MRSA characteristics is limited, including SCCmec types, in primary or secondary care facilities. A total of 128 MRSA isolates (90 skin and soft tissue isolates and 38 blood isolates) were collected at a secondary care facility, Kawatana Medical Center, from 2005 to 2011. Antimicrobial susceptibility testing for anti-MRSA antibiotics and molecular testing for SCCmec and virulence genes (tst, sec, etb, lukS/F-PV) were performed. Strains positive for lukS/F-PV were analyzed by multilocus sequence typing and phage open-reading frame typing. SCCmec typing in skin and soft tissue isolates revealed that 65.6% had type IV, 22.2% had type II, 8.9% had type I, and 3.3% had type III. In blood isolates, 50.0% had type IV, 47.4% had type II, and 2.6% had type III. Minimum inhibitory concentrations, MIC(50)/MIC(90), against vancomycin, teicoplanin, linezolid, and arbekacin increased slightly in SCCmec II isolates from skin and soft tissue. MICs against daptomycin were similar between sites of isolation. SCCmec type II isolates possess tst and sec genes at a greater frequently than SCCmec type IV isolates. Four lukS/F-PV-positive isolates were divided into two clonal patterns and USA300 was not included. In conclusion, SCCmec type IV was dominant in blood, skin, and soft tissue isolates in a secondary care facility in Japan. Because antimicrobial susceptibility varies with the SCCmec type, SCCmec typing of clinical isolates should be monitored in primary or secondary care facilities.
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. Electronic address: y-morina@nagasaki-u.ac.jp.
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Morinaga
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Akamatsu
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Matsuda
authors.affiliation: Department of Respiratory Internal Medicine, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamaryo
authors.affiliation: Department of Respiratory Internal Medicine, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawakami
authors.affiliation: Department of Clinical Research, National Hospital Organization Nagasaki Kawatana Medical Center, Nagasaki, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsuo
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kosai
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Uno
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Hasegawa
authors.affiliation: Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yanagihara
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000097:blood; D001427:Bacterial Toxins; D003428:Cross Infection / Q000097:blood / Q000188:drug therapy* / Q000382:microbiology*; D017576:Daptomycin / Q000627:therapeutic use; D003982:Dibekacin / Q000031:analogs & derivatives / Q000627:therapeutic use; D005098:Exotoxins; D006801:Humans; D007564:Japan; D007956:Leukocidins; D000069349:Linezolid / Q000627:therapeutic use; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D058885:Multilocus Sequence Typing; D016366:Open Reading Frames; D045522:Recombinases / Q000097:blood; D063728:Secondary Care Centers; D012867:Skin / Q000382:microbiology; D018461:Soft Tissue Infections / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification; D017334:Teicoplanin / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use; D037521:Virulence Factors
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; C489156:CcrC protein, Staphylococcus aureus; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D045522:Recombinases; D037521:Virulence Factors; D003982:Dibekacin; D017334:Teicoplanin; D014640:Vancomycin; C031986:arbekacin; D000069349:Linezolid; D017576:Daptomycin
keywords: Community-acquired methicillin-resistant Staphylococcus aureus; Panton-Valentine leukocidin; Phage open reading frame typing; SCCmec type