Abstract
Community-acquired Staphylococcus aureus is a major pathogen responsible for skin and soft tissue infections (SSTIs). This study aimed to investigate the prevalence and molecular characteristics of community-acquired S. aureus isolates recovered from paediatric patients with SSTIs in Shanghai, China. Between January 2015 and January 2018, 91 community-acquired S. aureus isolates were characterised by antibiotic susceptibility, multilocus sequence typing (ST), staphylococcal protein A gene (spa) type and virulence genes. Methicillin-resistant S. aureus (MRSA) strains were also characterised by staphylococcal cassette chromosome mec (SCCmec) type. Forty-one (45.1%) S. aureus isolates were MRSA. ST59 (33.0%, 30/91) was the most common sequence type, and t437 (18.7%, 17/91) was the most common spa type. SCCmec IV and V accounted for 61.0% and 34.1% of all MRSA isolates, respectively. Each isolate carried at least six virulence genes. The positive rates of Panton-Valentine leukocidin genes among all S. aureus, MRSA and methicillin-susceptible S. aureus isolates were 30.8% (28/91), 39.0% (16/41) and 24% (12/50), respectively. The prevalence of community-associated MRSA was surprisingly high among children with community-acquired SSTIs in Shanghai. ST59-t437 was the most prevalent community-acquired S. aureus clone causing SSTIs.
Highlights
Staphylococcus aureus is a major cause of skin and soft tissue infections (SSTIs) worldwide [1, 2]
The prevalence of CA-Methicillin-resistant S. aureus (MRSA) SSTIs was reported to be 57% in the US in 2004 [12], but there was no report of such infections in mainland China before 2009
A few studies reported that Community-associated methicillin-resistant S. aureus (CA-MRSA) accounted for 4.0% of community-acquired S. aureus SSTIs in Beijing, 3.4% in Guangzhou and 10.3% in Wuhan [13,14,15]
Summary
Staphylococcus aureus is a major cause of skin and soft tissue infections (SSTIs) worldwide [1, 2]. Community-associated methicillin-resistant S. aureus (CA-MRSA) has been a global concern since it emerged in the 1990s. CA-MRSA strains can cause nosocomial infections, and healthcare-associated MRSA (HA-MRSA) strains do circulate in the community, CA-MRSA is epidemiologically, clinically and genetically different from HA-MRSA [3]. CA-MRSA infections tend to occur in otherwise healthy younger patients with SSTIs; such strains may be susceptible to a wider range of antibiotics, and usually harbour the staphylococcal cassette chromosome mec (SCCmec) types IV or V. The global epidemic of CA-MRSA continues to evolve, and the potential shift of epidemic clones at the local, national and international levels is of great interest
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