Isobe Hirokazu, Miyasaka Dai, Ito Tomoyuki, Takano Tomomi, Nishiyama Akihito, Iwao Yasuhisa, Khokhlova Olga E, Okubo Takeshi, Endo Naoto, Yamamoto Tatsuo
Division of Bacteriology, Department of Infectious Disease Control and International Medicine Division of Orthopaedic Surgery, Department of Reconstructive and Transplant Medicine, Niigata, Japan.
Pediatr Int. 2013 Feb;55(1):120-3. doi: 10.1111/j.1442-200X.2012.03612.x.
A 17-year-old female patient (a basketball player) suffered from recurrent pelvic abscesses from methicillin-resistant Staphylococcus aureus (MRSA). The first episode, from strain NN12, occurred in October 2004. Her cutaneous abscesses complicated into systemic progression to osteomyelitis and multifocal pelvic abscesses, adjacent to the sacroiliac joint. The second episode, abscesses at tissues adjacent to the sacroiliac joint from strain NN31A, occurred late in February 2005. The third episode, from strain NN31B, occurred on July 30, 2005, repeating the second episode. Three MRSA strains were identical in terms of genotypes (belonging to Panton-Valentine leukocidin [PVL]-positive ST30 community-acquired MRSA, CA-MRSA), pulsed-field gel electrophoresis patterns, and peptide cytolysin gene (psmα) expression levels. The three MRSA strains exhibited superior THP-1 cell invasion ability over hospital-acquired MRSA (New York/Japan clone). The data suggest that PVL-positive ST30 CA-MRSA, with high levels of cell invasion and peptide cytolysins, causes recurrence of pelvic abscesses in a healthy adolescent.
一名17岁女性患者（篮球运动员）因耐甲氧西林金黄色葡萄球菌（MRSA）反复出现盆腔脓肿。首次发作由NN12菌株引起，发生于2004年10月。她的皮肤脓肿发展为全身性病变，进而引发骨髓炎和多灶性盆腔脓肿，脓肿位于骶髂关节附近。第二次发作由NN31A菌株引起，于2005年2月下旬在骶髂关节附近组织出现脓肿。第三次发作由NN31B菌株引起，发生于2005年7月30日，情况与第二次发作相同。这三株MRSA菌株在基因型（属于杀白细胞素[PVL]阳性的ST30社区获得性MRSA，即CA-MRSA）、脉冲场凝胶电泳图谱以及肽溶素基因（psmα）表达水平方面均相同。这三株MRSA菌株对THP-1细胞的侵袭能力优于医院获得性MRSA（纽约/日本克隆株）。数据表明，具有高水平细胞侵袭能力和肽溶素的PVL阳性ST30 CA-MRSA会导致健康青少年盆腔脓肿复发。
