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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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References
  1. Ho  PL, Chuang  SK, Choi  YF, Lee  RA, Lit  AC, Ng  TK, Community-associated methicillin-resistant and methicillin-sensitive Staphylococcus aureus: skin and soft tissue infections in Hong Kong. Diagn Microbiol Infect Dis. 2008;61:24550. DOIPubMed
  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. DOIPubMed
  3. Ho  PL, Lai  EL, Chow  KH, Chow  LS, Yuen  KY, Yung  RW. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in residential care homes for the elderly in Hong Kong. Diagn Microbiol Infect Dis. 2008;61:13542. DOIPubMed
  4. Ho  PL, Wang  TK, Ching  P, Mak  GC, Lai  E, Yam  WC, Epidemiology and genetic diversity of methicillin-resistant Staphylococcus aureus strains in residential care homes for elderly persons in Hong Kong. Infect Control Hosp Epidemiol. 2007;28:6718. DOIPubMed
  5. Finlay  JE, Miller  LA, Poupard  JA. Interpretive criteria for testing susceptibility of staphylococci to mupirocin. Antimicrob Agents Chemother. 1997;41:11379.PubMed
  6. Perez-Roth  E, Claverie-Martin  F, Villar  J, Mendez-Alvarez  S. Multiplex PCR for simultaneous identification of Staphylococcus aureus and detection of methicillin and mupirocin resistance. J Clin Microbiol. 2001;39:403741. DOIPubMed
  7. Denis  O, Deplano  A, De Beenhouwer  H, Hallin  M, Huysmans  G, Garrino  MG, Polyclonal emergence and importation of community-acquired methicillin-resistant Staphylococcus aureus strains harbouring Panton-Valentine leucocidin genes in Belgium. J Antimicrob Chemother. 2005;56:11036. DOIPubMed
  8. Yu  F, Chen  Z, Liu  C, Zhang  X, Lin  X, Chi  S, Prevalence of Staphylococcus aureus carrying Panton-Valentine leukocidin genes among isolates from hospitalised patients in China. Clin Microbiol Infect. 2008;14:3814. DOIPubMed
  9. Zaoutis  TE, Toltzis  P, Chu  J, Abrams  T, Dul  M, Kim  J, Clinical and molecular epidemiology of community-acquired methicillin-resistant Staphylococcus aureus infections among children with risk factors for health care–associated infection: 2001–2003. Pediatr Infect Dis J. 2006;25:3438. DOIPubMed
  10. Ghebremedhin  B, Olugbosi  MO, Raji  AM, Layer  F, Bakare  RA, Konig  B, Emergence of a community-associated methicillin-resistant Staphylococcus aureus strain with a unique resistance profile in Southwest Nigeria. J Clin Microbiol. 2009;47:297580. DOIPubMed

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Page updated: June 08, 2011
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