Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Med Sci. 2012 Mar;27(3):313-6. doi: 10.3346/jkms.2012.27.3.313. Epub 2012 Feb 23.
Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.
Panton-Valentine 白细胞毒素 (PVL)-阳性 USA300 克隆是在北美传播最成功的社区相关耐甲氧西林金黄色葡萄球菌 (CA-MRSA) 克隆。相比之下，PVL 阴性 ST72-CA-MRSA 则在韩国占主导地位，除了一例肛周感染的病例报告外，尚未有 USA300 株引起感染的报告。在此，我们描述了韩国首例大流行性流感 A (H1N1) 后由 USA300 株引起的肺炎病例。一名 50 岁男性因发热和咳嗽入院，胸部 X 线片显示右下肺区肺炎性实变。由于呼吸衰竭，他接受了呼吸机支持。鼻咽拭子中甲型流感大流行 A (H1N1) 的 PCR 检测呈阳性，痰和气管内抽吸物的培养均生长出耐甲氧西林金黄色葡萄球菌。分离株的分型显示其为 PVL 阳性、ST8-MRSA-SCCmec 型 IV。PFGE 模式分析表明，该分离株与 USA300 株的脉冲场凝胶电泳图谱相同。
