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Park, Kim, Kim, and Hwang: Molecular Characterization of Community-Associated Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Isolates from Children with Skin Infections in Busan, Korea
Original Article

J Bacteriol Virol 2015;45(2):104-111.

Published online: 9 February 2015

DOI: https://doi.org/10.4167/jbv.2015.45.2.104

Molecular Characterization of Community-Associated Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Isolates from Children with Skin Infections in Busan, Korea

So Hae Park1, Ki Ju Kim1, Byoung Kuk Kim2, Soo Myung Hwang1, ∗

1Department of Clinical Laboratory Science, Catholic University of Pusan, Busan, Korea

2Department of Laboratory Medicine, Busan St. Mary's Hospital, Busan, Korea

∗Corresponding author: Soo Myung Hwang. Department of Clinical Laboratory Science, Catholic University of Pusan, Busan 609-757, Korea. Phone: +82-51-510-0563, Fax: +82-51-510-0568, e-mail: smhwang@cup.ac.kr

Received 1 May 201511 May 2015       Accepted 13 May 2015

Copyright © 2015 Journal of Bacteriology and Virology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The prevalence and molecular characteristics of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) and methicillin-susceptible S. aureus (CA-MSSA) from children with skin infection were investigated by staphylocoagulase (SC) typing, multilocus sequence typing (MLST), SCC mec typing and virulent toxins, including Panton-Valentine leucocidin (PVL), and exfoliative toxins (ET). Among 69 cases of CA-S. aureus for a 3 month period from March to June, 2014 at hospital in Busan, 28 (40.6%) were MRSA and 41 (59.4%) were MSSA. Of the 28 CA-MRSA isolates, two major clones were identified as SC type Vb-ST72-SCC mec type IV (53.6%) and SC type l-ST89-SCC mec type II variant (42.8%), and the remaining one (3.6%) was SC type lll-ST8-SCC mec type IV. In CA-MSSA, the prevalent clone was SC type Vb-ST72 (29.3%), followed by SC type Vb-ST188 (21.9%), SC type Va-ST121 (19.5%) and SC type lV-ST30 (9.6%). None was positive for PVL gene, and all of the SC type l-ST89-SCC mec type II variant clones were ETB gene positive. The data suggest that there are significant clonal relatedness with specific SC types, and genetic diversities in both community strains isolated from children with skin infections.

Keywords: Community-associated MRSA, Staphylocoagulase type, Sequence type, SCC mec type, Skin infection

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Table 1.
Distribution of staphylocoagulase types in CA-MRSAa and CA-MSSAb isolates
SC typec No. (%) of isolates
MRSA MSSA Total
l 12 (42.8) 0 12 (17.4)
ll 0 0 0
lll 1 (3.6) 0 1 (1.4)
lV 0 6 (14.6) 6 (8.7)
Va 0 8 (19.5) 8 (11.6)
Vb 15 (53.6) 21 (51.2) 36 (52.1)
Vl 0 0 0
Vll 0 3 (7.3) 3 (4.3)
Vlll 0 3 (7.3) 3 (4.3)
lX 0 0 0
X 0 0 0
Total 28 (100) 41 (100) 69 (100)

a CA-MRSA: community-associated methicillin-resistant Staphylococcus aureus,

b MSSA: methicillin-susceptible Staphylococcus aureus,

c Staphylocoagulase type

Table 2.
Molecular characteristics of 28 CA-MRSA isolates
SC type No. (%) of isolate MLSTa SCC mecc type Toxin gene
STb Allelic profile pvl eta etb
l 12 (42.8) ST89 (42.8) 1-26-28-18-18-33-50 II variant 0 0 12
lll 1 (3.6) ST8 (3.6) 3-3-1-1-4-4-3 IV 0 0 0
Vb 15 (53.6) ST72 (53.6) 1-4-1-8-4-4-3 IV 0 0 2

a MLST: multilocus sequence typing,

b ST: sequence type,

c SCC mec: staphylococcal cassette chromosome mec

Table 3.
Molecular characteristics of 41 CA-MSSA isolates
SC type No. (%) of isolates MLSTa Toxin gene
STb Allelic profile pvl eta etb
lV 6 (14.6) ST30 (9.7) 2-2-2-2-6-3-2 0 0 0
    ST6 (4.9) 12-4-1-4-12-1-3 0 0 0
Va 8 (19.5) ST121 (19.5) 6-5-6-2-7-14-5 0 4 0
Vb 21 (51.2) ST72 (29.3) 1-4-1-8-4-4-3 0 0 0
    ST188 (21.9) 3-1-1-8-1-1-1 0 0 0
Vll 3 (7.3) ST1 (7.3) 1-1-1-1-1-1-1 0 0 0
Vlll 3 (7.3) ST20 (7.3) 4-9-1-8-1-10-8 0 0 0

a MLST: multilocus sequence typing,

b ST: sequence type

Table 4.
Antimicrobial resistant rates of the CA-MRSA and MSSA isolates according to sequence types
Antimicrobial agent CA-MRSA CA-MSSA
ST72 (n=15) ST89 (n=12) ST8 (n=1) Total n (%) ST72 (n=12) ST188(n=9) ST121(n=8) ST30 (n=4) ST6 (n=2) ST1 (n=3) ST20 (n=3) Total n (%)
Oxacillin 15 (100) 12 (100) 1 (100) 28 (100) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Clindamycin 4 (26) 10 (83) 0 (0) 14 (50) 0 (0) 0 (0) 2 (25) 0 (0) 2 (100) 0 (0) 0 (0) 4 (9)
Erythromycin 4 (26) 10 (83) 0 (0) 14 (50) 0 (0) 2 (22) 3 (37) 0 (0) 2 (100) 0 (0) 0 (0) 7 (17)
Gentamycin 4 (26) 9 (75) 1 (100) 14 (50) 4 (33) 4 (44) 2 (25) 0 (0) 0 (0) 0 (0) 2 (66) 12 (29)
Fucidic acid 0 (0) 0 (0) 0 (0) 0 (0) 12 (100) 2 (22) 7 (87) 0 (0) 0 (0) 2 (66) 2 (66) 25 (60)
Ciprofloxacin 1 (6) 0 (0) 0 (0) 1 (3) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Mupirocin 5 (33) 6 (50) 0 (0) 11 (39) 3 (25) 3 (33) 3 (39) 0 (0) 0 (0) 0 (0) 0 (0) 9 (21)
Telithromycin 0 (0) 5 (41) 0 (0) 5 (17) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
Tetracycline 3 (20) 1 (8) 0 (0) 4 (14) 1 (8) 3 (33) 1 (12) 0 (0) 0 (0) 0 (0) 0 (0) 5 (12)
Vancomycin 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0)
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