title: Molecular characteristics of community-acquired methicillin-resistant Staphylococcus aureus strains isolated from outpatients with skin and soft tissue infections in Wuhan, China.
abstract: This study aims to investigate the antimicrobial susceptibility, molecular characteristics and virulence genes of community-acquired methicillin-resistant ITALIC! Staphylococcus aureus(CA-MRSA) isolates with skin and soft tissue infections (SSTIs). Outpatients with SSTIs visiting five medical and health institutions were enrolled from 2011 to 2013. Available ITALIC! S. aureus isolates were characterized by antimicrobial susceptibility testing, and detection of PVL genes. For CA-MRSA isolates, we performed typing of staphylococcal cassette chromosome ITALIC! mec(SCC ITALIC! mec), multi locus sequence typing (MLST) and carriage of 27 virulence genes. A total of 203 ITALIC! S. aureusstrains were isolated from 1400 outpatients with SSTIs, and 21 (10.3%) were CA-MRSA isolates. The positive rate of PVL genes among ITALIC! S. aureus, CA-MRSA and methicillin-susceptible ITALIC! S. aureus(MSSA) isolates were 39.4%, 71.4% and 35.7%, respectively. CA-MRSA strains had greater sensitivity to non-β-lactam antimicrobial agents. All CA-MRSA isolates belonged to SCC ITALIC! mecIV and V, accounting for 47.6% and 52.4%, respectively. ST59 was the most common lineage accounting for 76.2%; ST59-SCC ITALIC! mecIVa-PVL-positive clone was found to be the predominant clone, accounting for 38.1%. All CA-MRSA isolates were found to be positive for one or more virulence genes, 28.6% of isolates carried PVL, ITALIC! seb, ITALIC! sek, ITALIC! seq, ITALIC! hla, ITALIC! hlb, ITALIC! hldand ITALIC! hlg-2. CA-MRSA infections were relatively uncommon in outpatients with SSTIs, but they carried many virulence genes, ST59-SCC ITALIC! mecIV a-PVL-positive clone was the predominant clone in Wuhan, China.
authors.affiliation: Department of Disinfection and Pest Control, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Disinfection and Pest Control, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China wh-ljs@sohu.com.
authors.forename: Jiansheng
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Pathogenic Biological Detection, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China.
authors.forename: Yuanshan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Disinfection and Pest Control, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Nursing, Wuhan No. 1 Hospital, No. 215 Zhongshandadao Road, Wuhan, Hubei 430022, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yuan
authors.affiliation: Department of Infection Control, Huangpi People's Hospital, No. 259 Qianchuanbaixiu street, Wuhan, Hubei 430300, China.
authors.forename: Lihua
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Infection Control, Wuhan Fifth Hospital, No. 122 Xianzheng Street, Wuhan, Hubei 430050, China.
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Disinfection and Pest Control, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China.
authors.forename: Huiqiong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Office, Wuhan Centers for Disease Prevention and Control, No. 24 Jianghanbeilu Road, Wuhan, Hubei 430015, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification* / Q000187:drug effects / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010045:Outpatients; D015995:Prevalence; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors
keywords: PVL; antimicrobial susceptibility; community-acquired methicillin-resistant Staphylococcus aureus; molecular characteristics; skin and soft tissue infections; virulence genes