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 9, Number 8—August 2003
Research

Community-Acquired Methicillin-Resistant Staphylococcus aureus Carrying Panton-Valentine Leukocidin Genes: Worldwide Emergence

François Vandenesch*, Timothy Naimi†, Mark C. Enright‡, Gerard Lina*, Graeme R. Nimmo§, Helen Heffernan¶, Nadia Liassine#, Michèle Bes*, Timothy Greenland**, Marie-Elisabeth Reverdy*, and Jerome Etienne*Comments to Author 
Author affiliations: *INSERM E0230, Lyon, France; †Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ‡University of Bath, Bath, United Kingdom; §Princess Alexandra Hospital, Brisbane, Australia; ¶Antibiotic Reference Laboratory, 12 Wellington, New Zealand; #Laboratoire Bioanalytique-Riotton, Geneva, Switzerland; **UMR754, Lyon, France

Main Article

Table 1

Distribution of virulence and resistance determinants in 117 CA-MRSA isolates from three continentsa

Genesb CA-MRSA isolates from
France- Switzerlandc
n=67 (%) USA
n=29 (%) USA
n=4 (%) Oceaniad
Southwest Pacific clone n=13 (%) Australia
Queensland clone
n=4 (%) Total
n=117 (%)
Sequence type 80 1 59 or 8 30 93
PFGE pattern A1-7 B1-5 D1 & F1 C1-3 E1
agr type 3 3 1 3 3
SCCmec type IVa 67 (100) 29 (100) 4 (100) 13 (100) 4 (100) 117 (100)
Leukocidins PVL genes 67 (100) 29 (100) 4 (100) 13 (100) 4 (100) 117 (100)
lukE-lukD 67 (100) 29 (100) 3 (75) 13 (100) 0 (0) 116 (99)
Hemolysinse
hlg 0 (0) 0 (0) 0 (0) 13 (100) 0 (0) 13 (11)
hlg-v 67 (100) 29 (100) 4 (100) 0 (0) 0 (0) 100 (85)
hlb 0 (0) 0 (0) 1 (25) 0 (0) 0 (0) 1 (1)
Enterotoxins sea 0 (0) 23 (79) 0 (0) 0 (0) 0 (0) 23 (20)
seb 0 (0) 8 (28) 1 (25) 0 (0) 0 (0) 9 (8)
sec 0 (0) 20 (69) 0 (0) 0 (0) 0 (0) 20 (17)
sed-sej 0 (0) 0 (0) 3 (75) 0 (0) 0 (0) 3 (3)
she 0 (0) 29 (100) 0 (0) 0 (0) 0 (0) 29 (25)
sek 0 (0) 24 (83) 0 (0) 0 (0) 0 (0) 24 (21)
egcf 0 (0) 0 (0) 0 (0) 13 (100) 0 (0) 13 (11)

aPFGE, Pulsed-field gel electrophoresis; PVL, Panton-Valentine leukocidin.
bResults for toxin genes absent from all community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) isolates (see, tst, eta, etb, lukM, and edinA) are not presented.
cIsolates from France (61) and Switzerland (6).
dIsolates from Australia (8), New Zealand (4) and Western Samoa (1).
ehlg, γhaemolysin gene; hlg-v, γ-haemolysin variant gene; hlb, β-haemolysin gene.
fegc: enterotoxin gene cluster, which includes the seg, sei, sem, sen, and seo gene

Main Article

References
  1. Diekema  DJ, Pfaller  MA, Schmitz  FJ, Smayevsky  J, Bell  J, Jones  RN, Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis. 2001;32(Suppl 2):S11432. DOIPubMedGoogle Scholar
  2. Naimi  TS, LeDell  KH, Boxrud  DJ, Groom  AV, Steward  CD, Johnson  SK, Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996–1998. Clin Infect Dis. 2001;33:9906. DOIPubMedGoogle Scholar
  3. Dufour  P, Gillet  Y, Bes  M, Lina  G, Vandenesch  F, Floret  D, Community-acquired methicillin-resistant Staphylococcus aureus infections in France: emergence of a single clone that produces Panton-Valentine leukocidin. Clin Infect Dis. 2002;35:81924. DOIPubMedGoogle Scholar
  4. Okuma  K, Iwakawa  K, Turnidge  JD, Grubb  WB, Bell  JM, O’Brien  FG, Dissemination of new methicillin-resistant Staphylococcus aureus clones in the community. J Clin Microbiol. 2002;40:428994. DOIPubMedGoogle Scholar
  5. Adhikari  RP, Cook  GM, Lamont  I, Lang  S, Heffernan  H, Smith  JM. Phenotypic and molecular characterization of community occurring, Western Samoan phage pattern methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother. 2002;50:82531. DOIPubMedGoogle Scholar
  6. Baba  T, Takeuchi  F, Kuroda  M, Yuzawa  H, Aoki  K, Oguchi  A, Genome and virulence determinants of high virulence community-acquired MRSA. Lancet. 2002;359:181927. DOIPubMedGoogle Scholar
  7. Lina  G, Piemont  Y, Godail-Gamot  F, Bes  M, Peter  MO, Gauduchon  V, Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999;29:112832. DOIPubMedGoogle Scholar
  8. Gillet  Y, Issartel  B, Vanhems  P, Fournet  JC, Lina  G, Bes  M, Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet. 2002;359:7539. DOIPubMedGoogle Scholar
  9. Nimmo  GR, Schooneveldt  J, O’ane  G, McCall  B, Vickery  A. Community acquisition of gentamicin-sensitive methicillin-resistant Staphylococcus aureus in southeast Queensland, Australia. J Clin Microbiol. 2000;38:392631.PubMedGoogle Scholar
  10. Munckhof  WJ, Schooneveldt  J, Coombs  GW, Hoare  J, Nimmo  GR. Emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection in Queensland, Australia. Int J Infect Dis. 2003. In press. DOIPubMedGoogle Scholar
  11. Gosbell  IB, Mercer  JL, Neville  SA, Crone  SA, Chant  KG, Jalaludin  BB, Non-multiresistant and multiresistant methicillin-resistant Staphylococcus aureus in community-acquired infections. Med J Aust. 2001;174:62730.PubMedGoogle Scholar
  12. Nimmo  G, Playford  E. Community-acquired MRSA bacteraemia: four additional cases including one associated with severe pneumonia. Med J Aust. 2003;178:245.PubMedGoogle Scholar
  13. Lelievre  H, Lina  G, Jones  ME, Olive  C, Forey  F, Roussel-Delvallez  M, Emergence and spread in French hospitals of methicillin-resistant Staphylococcus aureus with increasing susceptibility to gentamicin and other antibiotics. J Clin Microbiol. 1999;37:34527.PubMedGoogle Scholar
  14. de l'Antibiogramme de le Société Française de Microbiologie  C. Zone sizes and MIC breakpoints for non-fastidious organisms. Clin Microbiol Infect. 1996;2(Suppl. 1):S149.PubMedGoogle Scholar
  15. Oliveira  D, de Lencastre  H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec element in methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2002;46:215561. DOIPubMedGoogle Scholar
  16. Jarraud  S, Mougel  C, Thioulouse  J, Lina  G, Meugnier  H, Forey  F, Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun. 2002;70:63141. DOIPubMedGoogle Scholar
  17. Inoue  S, Sugai  M, Murooka  Y, Paik  SY, Hong  YM, Ohgai  H, Molecular cloning and sequencing of the epidermal cell differentiation inhibitor gene from Staphylococcus aureus. Biochem Biophys Res Commun. 1991;174:45964. DOIPubMedGoogle Scholar
  18. Jarraud  S, Peyrat  MA, Lim  A, Tristan  A, Bes  M, Mougel  C, egc, a highly prevalent operon of enterotoxin gene, forms a putative nursery of superantigens in Staphylococcus aureus. J Immunol. 2001;166:66977.PubMedGoogle Scholar
  19. Goering  RV, Winters  MA. Rapid method for epidemiological evaluation of gram-positive cocci by field inversion gel electrophoresis. J Clin Microbiol. 1992;30:57780.PubMedGoogle Scholar
  20. Tenover  FC, Arbeit  RD, Goering  RV, Mickelsen  PA, Murray  BE, Persing  DH, Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995;33:22339.PubMedGoogle Scholar
  21. Enright  MC, Day  NP, Davies  CE, Peacock  SJ, Spratt  BG. Multilocus sequence typing for characterization of methicillin- resistant and methicillin-susceptible clones of Staphylococcus aureus. J Clin Microbiol. 2000;38:100815.PubMedGoogle Scholar
  22. Ma  XX, Ito  T, Etienne  J, Okuma  K, Hiramatsu  K. Historical distribution of SCCmec allotype in healthcare-associated MRSA strains in Japan and France. 10th International Symposium on Staphylococci and Staphylococcal Infections. Tsukuba, Japan; 2002;Oct 16–19:Abstract 299.
  23. Oliveira  DC, Tomasz  A, de Lencastre  H. The evolution of pandemic clones of methicillin-resistant Staphylococcus aureus: identification of two ancestral genetic backgrounds and the associated mec elements. Microb Drug Resist. 2001;7:34961. DOIPubMedGoogle Scholar
  24. Collignon  P, Gosbell  I, Vickery  A, Nimmo  G, Stylianopoulos  T, Gottlieb  T. Community-acquired meticillin-resistant Staphylococcus aureus in Australia. Australian Group on Antimicrobial Resistance. Lancet. 1998;352:1456. DOIPubMedGoogle Scholar
  25. Daum  RS. Community-acquired methicillin-resistant Staphylococcus aureus infections. Pediatr Infect Dis J. 1998;17:7456. DOIPubMedGoogle Scholar

Main Article

Page created: December 22, 2010
Page updated: December 22, 2010
Page reviewed: December 22, 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