Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 14, Number 8—August 2008
Letter

Pediatric Pneumonia Death Caused by Community-acquired Methicillin-Resistant Staphylococcus aureus, Japan

Takashi Ito*, Makiko Iijima*, Takayoshi Fukushima*, Masato Nonoyama*, Masahiro Ishii*, Tatiana Baranovich†, Taketo Otsuka†, Tomomi Takano†, and Tatsuo Yamamoto†
Author affiliations: *Kitasato University School of Medicine, Kanagawa, Japan; †Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;

Main Article

Table

Characteristics of PVL-positive MRSA strains reported in Japan since 2000*

Type, gene, or resistancePVL-positive MRSA
Present strain
Previous strains
NN32NN1NN12, NN31EB 00449DB 00319
TypesCC3030303030
ST30303030765
spa1919191943
agr33333
SCCmecIVaIVcIVcIVcIVx*

Coagulase
IV

IV
IV
IV
IV
Toxins
LeukocidinslukS-PV, lukF-PV†+++++
lukE-lukD, lukM
Hemolysinshla, hlg, hld+++++
hlb+
hlg–v
Staphylococcal enterotoxinssea+
tst, seb, sec, 
sed, see, seh, 
sej, sek, sep
egc‡+++++
seu+++++
Exfoliative toxinseta, etb, etd
Othersset+++++

edin






Adhesins
icaA, sdrD, sdrE

icaD, cna,§
eno, fnbA,
fnbB, ebpS,clfA, clfB, fib, 
sdrC, bbp¶
+

+
+
+
+
Drug resistance and penicillinase plasmidAminoglycosidesGEN#
KAN#*GEN**
KAN**
STR**
MacrolidesERY**
LincosamidesCLI**
TetracyclineTET#
Penicillinase plasmid (kb)+ 
(33)+ 
(33)+ 
(33)+ 
(33)+ 
(40)**

*PVL, Panton-Valentine leukocidin; MRSA, methicillin-resistant Staphylococcus aureus; SCCmec IVx, staphylococcal cassette chromosome mec type IV with unknown subtypes; +, positive; ­­–, negative; GEN, gentamicin; KAN, kanamycin; STR, streptomycin; ERY, erythromycin; CLI, clindamycin; TET, tetracycline.
†GenBank accession nos. for the PVL gene sequences from strains NN32 and NN1 are AB286959 and AB186917, respectively.
egc, enterotoxin gene cluster, including seg, sei, sem, sen, and seo genes.
§cna, gene encoding for collagen binding protein (adhesin).
bbp, gene encoding for bone sialoprotein binding protein (adhesin).
#Drug resistance encoded by a conjugative drug resistance plasmid (pGKT1) (8).
**Multidrug-resistant penicillinase plasmid encoding for resistance to GEN, KAN, STR, ERY, and CLI, in addition to penicillin resistance (9).

Main Article

References
  1. Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus—Minnesota and North Dakota, 1997–1999.JAMA. 1999;282:11235. DOIPubMedGoogle Scholar
  2. Tristan A, Bes M, Meugnier H, Lina G, Bozdogan B, Courvalin P, Global distribution of Panton-Valentine leukocidin–positive methicillin-resistant Staphylococcus aureus, 2006.Emerg Infect Dis. 2007;13:594600.PubMedGoogle Scholar
  3. Zetola N, Francis JS, Nuermberger EL, Bishai WR. Community-acquired methicillin-resistant Staphylococcus aureus: an emerging threat.Lancet Infect Dis. 2005;5:27586. DOIPubMedGoogle Scholar
  4. Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, Severe community-acquired pneumonia due to Staphylococcus aureus, 2003–04 influenza season.Emerg Infect Dis. 2006;12:8949.PubMedGoogle Scholar
  5. Labandeira-Rey M, Couzon F, Boisset S, Brown EL, Bes M, Benito Y, Staphylococcus aureus Panton-Valentine leukocidin causes necrotizing pneumonia.Science. 2007;315:11303. DOIPubMedGoogle Scholar
  6. Voyich JM, Otto M, Mathema B, Braughton KR, Whitney AR, Welty D, Is Panton-Valentine leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease?J Infect Dis. 2006;194:176170. DOIPubMedGoogle Scholar
  7. Bubeck Wardenburg J, Bae T, Otto M, Deleo FR, Schneewind O. Poring over pores: alpha-hemolysin and Panton-Valentine leukocidin in Staphylococcus aureus pneumonia.Nat Med. 2007;13:14056. DOIPubMedGoogle Scholar
  8. Takizawa Y, Taneike I, Nakagawa S, Oishi T, Nitahara Y, Iwakura N, A Panton-Valentine leucocidin (PVL)-positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA) strain, another such strain carrying a multiple-drug resistance plasmid, and other more-typical PVL-negative MRSA strains found in Japan.J Clin Microbiol. 2005;43:335663. DOIPubMedGoogle Scholar
  9. Yamamoto T, Dohmae S, Saito K, Otsuka T, Takano T, Chiba M, Molecular characteristics and in vitro susceptibility to antimicrobial agents, including the des-fluoro(6) quinolone DX-619, of Panton-Valentine leucocidin-positive methicillin-resistant Staphylococcus aureus isolates from the community and hospitals.Antimicrob Agents Chemother. 2006;50:407786. DOIPubMedGoogle Scholar
  10. Ferry T, Thomas D, Genestier AL, Bes M, Lina G, Vandenesch F, Comparative prevalence of superantigen genes in Staphylococcus aureus isolates causing sepsis with and without septic shock.Clin Infect Dis. 2005;41:7717. DOIPubMedGoogle Scholar

Main Article

Page created: July 12, 2010
Page updated: July 12, 2010
Page reviewed: July 12, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external