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Yoo, Kim, and Lee: ST714-SCCmec type IV CA-MRSA isolated from a Child with Recurrent Skin and Soft Tissue Infections in South Korea: A Case Report
Case Report

Pediatr Infect Vaccine 2016;23(1):62-66.

Published online: 21 January 2016

DOI: https://doi.org/10.14776/piv.2016.23.1.62

ST714-SCCmec type IV CA-MRSA isolated from a Child with Recurrent Skin and Soft Tissue Infections in South Korea: A Case Report

Reenar Yoo, Seohee Kim, Jina Lee

Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence: Jina Lee Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea Tel: +82-2-3010-3923, Fax: +82-2-473-3725 E-mail: entier@daum.net

Received 24 August 201514 October 2015       Accepted 14 October 2015

Copyright © 2016 The Korean Society of Pediatric Infectious Diseases

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

Skin and soft tissue infections (SSTIs) caused by community-associated (CA)-methicillin-resistant Staphylococcus aureus (MRSA) have become a worldwide concern. An otherwise healthy 16-month-old Korean girl was admitted because of skin abscess on the left chest wall with a history of recurrent SSTIs since the age of 6 months. Immunologic evaluation including serum immunoglobulin level and nitroblue—tetrazolium (NBT) test were normal. Pus and nasal swab cultures revealed CA-MRSA ST714-SCCmec type IV with the Panton-Valentine leukocidin(PVL) genes, which was initially reported in the Netherlands in 2006 and has not been previously reported in Korea. The skin abscesses were successfully treated by needle aspiration and the use of antibiotics. In addition, nasal mupirocin was applied as a decolonization method. No more episodes of SSTI were observed over a follow-up period of 10 months.

Keywords: Skin and soft tissue infections, Familial cluster, Decolonization, ST714, ST3O

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Table 1.
The Antibiotic-Susceptibility of the MRSA Isolates Obtained from the Patient and Her Father
Antibiotics Patient's pus culture Patient's nasal swab culture Patient's father's nasal swab culture
S/I/R (MIC) S/I/R(MIC) S/I/R(MIC)
Ampicillin R(>8) R(>8) R(>8)
Amoxicillin/clavulanate R(≤4/2) R(≤4/2) R(≤4/2)
Azithromycin S(≤2) S(≤2) S(≤2)
Clindamycin S(≤0.25) S(≤0.25) S(≤0.25)
Ciprofloxacin S(≤1) S(≤1) S(≤1)
Daptomycm S(≤1) S(≤1) S(≤1)
Erythromycin S(≤0.5) S(≤0.5) S(≤0.5)
Fusidic Acid S(≤2) S(≤2) S(≤2)
Fosfomycin S(≤32) S(≤32) S(≤32)
Gentamicin S(≤1) S(≤1) S(≤1)
Imipenem R(≤4) R(≤4) R(≤4)
Levofloxacin S(≤1) S(≤1) S(≤1)
Linezolid S(≤2) S(≤2) S(≤2)
Mupirocin S(≤4) S(≤4) s(≤4)
moxifloxacin S(≤0.5) S(≤0.5) S(≤0.5)
oxacillin R(>2) R(>2) R(>2)
Penicillin R(>8) R(>8) R(>8)
Rifampin S(≤1) S(≤1) S(≤1)
Quinupristin/Dalfopristin S(≤1) S(≤1) S(≤1)
Trimethoprim/Sulfamethoxazole S(≤2/38 S(≤2/38) S(≤2/38)
Tetracycline S(≤4) S(≤4) S(≤4)
Teicoplain S(≤4) S(≤4) S(≤4)
Vancomycin S(1) S(1) S(1)

Abbreviations: S, susceptible; I, Intermediate resistance; R, fully resistant; MIC, minimum inhibitory concentration.

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