title: Methicillin-Resistant Staphylococcus aureus Isolated From Various Types of Hospital Infections in Pediatrics: Panton-Valentine Leukocidin, Staphylococcal Chromosomal Cassette mec SCCmec Phenotypes and Antibiotic Resistance Properties.
abstract: BACKGROUND
  Staphylococcus aureus has long been considered as a major pathogen of hospital infections.
  
  
  OBJECTIVE
  The present investigation was carried out to study the distribution of Staphylococcal Chromosomal Cassette mec (SCCmec) types, Panton-Valentine Leukocidin (PVL) gene and antibiotic resistance properties of Methicillin Resistant Staphylococcus aureus (MRSA) strains isolated from various types of infections found in Iranian pediatric patients.
  
  
  METHODS
  Two-hundred and fifty-five clinical specimens were collected from four major provinces of Iran. Samples were cultured and the MRSA strains were subjected to Polymerase Chain Reaction (PCR). The patterns of antibiotic resistance were determined using the disk diffusion method.
  
  
  RESULTS
  Seventy-four out of 255 (29.01%) clinical samples were positive for MRSA. Of the 74 MRSA strains, 47 (63.51%) were PVL positive. The clinical samples of respiratory tract infections (36.36%), those from the Shiraz province (37.87%) and samples collected during the summer season (56.48%) were the most commonly infected samples. The most commonly detected antibiotic resistance genes were tetK (89.18%), mecA (71.62%), msrA (56.75%) and tetM (54.05%). Methicillin Resistant Staphylococcus aureus had the highest levels of resistance against penicillin (100%), tetracycline (98.64%), ampicillin (93.24%) and oxacillin (93.24%). The most commonly detected SCCmec types in the MRSA strains were type V (18.91%) and III (17.56%).
  
  
  CONCLUSIONS
  Regular surveillance of hospital-associated infections and monitoring of the antibiotic sensitivity patterns are required to reduce the prevalence of MRSA. We recommend initial management of children affected by MRSA with imipenem, lincomycin and cephalothin prescriptions.
authors: Department of Pediatric Nephrology, AJA University of Medical Sciences, Tehran, IR Iran.
authors: Banafshe
authors: B
authors: Dormanesh
authors: Department of Pediatric, AJA University of Medical Sciences, Tehran, IR Iran.
authors: Soheila
authors: S
authors: Siroosbakhat
authors: Young Researchers and Elite Club, North Tehran Branch, Islamic Azad University, Tehran, IR Iran.
authors: Ebrahim
authors: E
authors: Khodaverdi Darian
authors: Department of Pediatric Neurology, Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors: Ladan
authors: L
authors: Afsharkhas
keywords: Drug Resistance; Methicillin-resistant Staphylococcus aureus; Panton-Valentine Leukocidin