Takadama Shunsuke, Nakaminami Hidemasa, Aoki Sae, Akashi Megumi, Wajima Takeaki, Ikeda Masami, Mochida Atsushi, Shimoe Fumiko, Kimura Kumiko, Matsuzaki Yasushi, Sawamura Daisuke, Inaba Yoichi, Oishi Tomohiro, Nemoto Osamu, Baba Naoko, Noguchi Norihisa
Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan.
Department of Dermatology, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu, Kagawa 760-0017, Japan.
J Infect Chemother. 2017 Nov;23(11):800-803. doi: 10.1016/j.jiac.2017.04.016. Epub 2017 May 25.
The prevalence of Panton-Valentine leukocidin gene (pvl)-positive community-acquired methicillin-resistant Staphylococcus aureus USA300 clone, which is designated as the ST8-staphylococcal cassette chromosome (SCC) mec type IV (ST8-IV) lineage, is a major public health concern worldwide. Thus, to elucidate the prevalence and characteristics of pvl-positive community-onset MRSA in Japan, we conducted a molecular epidemiological analysis for 854 S. aureus isolates obtained from outpatients with skin infections during 2013 and 2014. The isolation rate of MRSA was 25.6% (219 isolates), and the ratio of pvl-positive MRSA was 13.2% (29 isolates). Notably, the proportion (93.8%) of pvl-positive isolates was particularly high among MRSA isolates from Ishigaki island in Okinawa. Pulsed-field gel electrophoresis and multilocus sequence typing showed that the pulsotype C isolates (11 isolates) were typical USA300 clones with arginine catabolic mobile element (ACME) type I-CC8-IV lineages and prevalent on the main island of Japan (Honshu). Pulsotypes A (11 isolates) and B (four isolates) consisted of ACME-negative CC8-IV clones and were specific for Ishigaki island. Both USA300 and Okinawa-Ishigaki specific clones were associated with deep-seated skin infections, such as furuncle and cellulitis. Pulsotypes D (two isolates) and E (one isolate) were ACME-negative clonal complex (CC) 59-IV clones and were related to superficial skin infections, such as impetigo. Our findings revealed that pvl-positive MRSA associated with deep-seated skin infections are spreading in Japanese communities, particularly in Ishigaki, Okinawa.
泛发性杀白细胞素基因（pvl）阳性的社区获得性耐甲氧西林金黄色葡萄球菌USA300克隆，即ST8-葡萄球菌盒式染色体（SCC）mec IV型（ST8-IV）谱系，其流行是全球主要的公共卫生问题。因此，为阐明日本pvl阳性社区起病的耐甲氧西林金黄色葡萄球菌的流行情况和特征，我们对2013年至2014年期间从皮肤感染门诊患者中分离出的854株金黄色葡萄球菌进行了分子流行病学分析。耐甲氧西林金黄色葡萄球菌的分离率为25.6%（219株），pvl阳性耐甲氧西林金黄色葡萄球菌的比例为13.2%（29株）。值得注意的是，在冲绳石垣岛的耐甲氧西林金黄色葡萄球菌分离株中，pvl阳性分离株的比例（93.8%）特别高。脉冲场凝胶电泳和多位点序列分型显示，脉冲型C分离株（11株）是典型的USA300克隆，具有I型精氨酸分解代谢移动元件（ACME）-CC8-IV谱系，在日本主岛（本州）流行。脉冲型A（11株）和B（4株）由ACME阴性的CC8-IV克隆组成，是石垣岛特有的。USA300和冲绳石垣岛特有的克隆均与深部皮肤感染有关，如疖和蜂窝织炎。脉冲型D（2株）和E（1株）是ACME阴性的克隆复合体（CC）59-IV克隆，与浅表皮肤感染有关，如脓疱病。我们的研究结果表明，与深部皮肤感染相关的pvl阳性耐甲氧西林金黄色葡萄球菌正在日本社区传播，尤其是在冲绳的石垣岛。
