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Volume 16, Number 4—April 2010

Letter

Panton-Valentine Leukocidin–Positive MRSA, Shanghai

Li-Zhong Han, Pak-Leung HoComments to Author , Yu-Xing Ni, Hong Zhang, Yan-Qun Jiang, Hai-Qing Chu, Yang Sun, and Yi-Bo Zhang
Author affiliations: Ruijin Hospital, Shanghai, People’s Republic of China (L.-Z. Han, Y.-X. Ni, Y.-B. Zhang); University of Hong Kong, Hong Kong Special Administrative Region, PRC (P.-L. Ho); Shanghai Children’s Hospital, Shanghai (H. Zhang); Sixth People’s Hospital of Shanghai, Shanghai (Y.-Q. Jiang); Shanghai Pulmonary Hospital, Shanghai (H.-Q. Chu); Minhang Central Hospital, Shanghai (Y. Sun)

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Table

Epidemiologic and microbiologic characteristics for Panton-Valentine leukocidin–positive MRSA infections in 9 case-patients, Shanghai, People’s Republic of China, 2006*

Strain Age/sex Admission
month Onset Diagnosis† Resistance pattern‡ Resistance determinants§ ST§ SCCmec spa type PFGE
D8 1 mo/F Feb HA Pneumonia Chl, Ery, Gen, Mup aacA-aphD, ermC, ileS-2 ST30 IV t318 SH100
D9 1 mo/F Feb CA Pneumonia Gen, Mup aacA-aphD, ileS-2 IV t318 SH100
D13 1 mo/M Mar HA Pneumonia Gen aacA-aphD IV t318 SH100
D14 3 mo/M Mar CA Pneumonia Gen aacA-aphD IV t318 SH100
D16 1 mo/M Mar CA Pneumonia Gen, Mup aacA-aphD, ileS-2 IV t318 SH100
D12 3 mo/F Mar HA Pneumonia Ery ermC ST1114 V t318 SH100
A18 29 y/M Mar HA Prostatitis None ST30 IV t3384 Singleton
D7 1 mo/F Jan CA Pneumonia Ery, Gen aacA-aphD, ermC ST88 V t1376 SH200
D18 4 mo/M Apr CA Pneumonia Ery, Gen aacA-aphD, ermC V t1376 SH200

*Strains are designated by hospital code and strain number. MRSA, methicillin-resistant Staphylococcus aureus; ST, sequence type; SCC, staphylococcal cassette chromosome; spa, staphylococcal protein A; PFGE, pulsed-field gel electrophoresis; HA, healthcare-associated; Chl, chloramphenicol; Ery, erythromycin; Gen, gentamicin, Mup, mupirocin; acA-aphD, aminoglycoside resistance gene encoding the bifunctional enzyme, 6'-aminoglycoside N-acetyltransferase/2”-aminoglycoside phosphotransferase; ermC, gene encoding macrolide-lincosamide-streptogramin B resistance; ileS-2, gene encoding high-level mupirocin resistance mediated by isoleucyl tRNA-synthetase; CA, community-associated.
†According to the diagnosis given in the computerized record. In the 8 children, MRSA was isolated from sputum specimens. One child also had MRSA isolated from pleural fluid. Because limited information was provided in the computerized records, some of the isolations may represent respiratory colonization. The outcomes of the 8 children were unknown.
‡According to disk diffusion test (1,5).
§Determined by PCR as described (4,6). ST30 (allelic profile 2–2-2–2-6–3-2) and ST114 (139–2-2–2-6–139–2) belonged to clonal complex 30.

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