Clinical features and molecular characteristics of childhood community-associated methicillin-resistant Staphylococcus aureus infection in a medical center in northern Taiwan, 2012

Hong-Kai Wang,Yhu-Chering Huang,Chun-Yen Huang

doi:10.1186/s12879-017-2560-0

Abstract

BackgroundSince first reported in 2002, the rate of methicillin-resistant Staphylococcus aureus (MRSA) among childhood community-associated (CA) S. aureus infection in Taiwan increased significantly up to 2005. There have been no reports on this issue since then.MethodsWe prospectively collected clinical S. aureus isolates from the patients <19 years of age in a university-affiliated hospital in 2012. Only first isolate from each patient was included. The medical records were retrospectively reviewed and the patients were classified as CA or healthcare-associated (HA) by the standard epidemiologic criteria. Isolates as CA-MRSA were further characterized by pulsed-field gel electrophoresis, staphylococcal cassette chromosome (SCCmec) typing, and multilocus sequence typing.ResultsA total of 409 S. aureus isolates were included, and 260 (63.6%) were MRSA. The proportion of MRSA among all S. aureus isolates in 2012 increased significantly (p < 0.001) compared to that in 2004–2005. Of the 181 CA-MRSA isolates, 86.2% were identified from pus or wound. Nine pulsotypes were identified with two major types (type D, 119 (65.7%); type C, 27 (14.9%). Most of the isolates carried either SCCmec IV (66 isolates, 36%) or VT (112 isolates, 62%). 128 isolates (71%) carried Panton-Valentine leukocidin (PVL) genes. Clonal complex (CC) 59 accounted for 146 isolates (80.7%) of two major pulsotypes, CC45 for 19 isolates, ST30 for 6 isolates and ST8 (USA 300) for 4 isolates. In addition to penicillin (100%), most isolates were resistant to erythromycin (81%) and clindamycin (79.3%).ConclusionsAround two-thirds of childhood community-associated S. aureus infections in northern Taiwan were MRSA. Though CC59 is still the prevalent community clone, several new clones emerged in northern Taiwan.

Highlights

Since first reported in 2002, the rate of methicillin-resistant Staphylococcus aureus (MRSA) among childhood community-associated (CA) S. aureus infection in Taiwan increased significantly up to 2005
We conducted this study to re-evaluate if the epidemiology, clinical manifestations and molecular characteristics of childhood community-associated MRSA (CA-MRSA) infections changed in the past decade in Taiwan
For the isolates identified in2008 and 2012, we retrospectively reviewed the medical records of the patients

Summary

Introduction

Since first reported in 2002, the rate of methicillin-resistant Staphylococcus aureus (MRSA) among childhood community-associated (CA) S. aureus infection in Taiwan increased significantly up to 2005. There have been no reports on this issue since . Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen, which can cause various infectious diseases from mild skin and soft tissue infection (SSTI) to fulminant septicemia. Since first report in 2002 [10], the rate of MRSA amongst childhood CA S. aureus infections increased significantly from 9.8% in 1999–2000 [10] to 55.7% in 2004–2005 [8]. There have been no reports published on this issue since 2005. We conducted this study to re-evaluate if the epidemiology, clinical manifestations and molecular characteristics of childhood CA-MRSA infections changed in the past decade in Taiwan

Methods

Results

Conclusion