title: Clinical and pathogenic features of SCCmec type II and IV methicillin-resistant Staphylococcus aureus in Japan.
abstract: Staphylococcal chromosomal cassette mec (SCCmec) type IV methicillin-resistant Staphylococcus aureus (MRSA) has rapidly disseminated in healthcare settings, and its characteristics in the United States and Europe are well known. Because Japanese SCCmec type IV MRSA clones are different and less well documented, this retrospective, single center study was done to determine and compare the characteristics of SCCmec type II and IV MRSA in Japan. For the analysis, 55 SCCmec type II and 101 type IV MRSA samples were collected from lower respiratory tract specimens or from skin or soft tissue. The patients of the SCCmec type IV group were significantly younger than those of the type II group (P < 0.001). The rate of MRSA pneumonia was significantly lower for SCCmec type IV than for type II (7.8% vs 29.0%, P = 0.026). In contrast, the rate of skin and soft tissue infection was not significantly different (66.0% vs 61.9%, P = 0.788). The distribution of MRSA pathogenic genes (sea, seb, sem, seo) was significantly different between SCCmec types II and IV (P < 0.001), which indicates that their clonal complex may be completely different. Interestingly, all SCCmec type II MRSA that caused MRSA pneumonia had seb and egc and lacked tst that belonged to sequence type (ST) 764. This is the first study to reveal and compare the characteristics of Japanese SCCmec type II and type IV MRSA. The information from this study will be helpful for the management of Japanese MRSA infection.
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Fujiko
authors.initials: F
authors.lastname: Mitsumoto-Kaseida
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Toyoda
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Yuiko
authors.initials: Y
authors.lastname: Morokuma
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Kiyosuke
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Dongchon
authors.initials: D
authors.lastname: Kang
authors.affiliation: Department of General Internal Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. Electronic address: furusyo@gim.med.kyushu-u.ac.jp.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Furusyo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D007564:Japan; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics*; D008875:Middle Aged; D011023:Pneumonia, Staphylococcal / Q000382:microbiology*; D015995:Prevalence; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000382:microbiology*; D013207:Staphylococcal Skin Infections; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: MRSA; Pneumonia; SCCmec type II; SCCmec type IV; ST764 SCCmec type II clone; Skin infection