2018•Microbial Drug ResistanceRequires access
Clinical and Molecular Characterization of Panton–Valentine Leukocidin-Positive Invasive Staphylococcus aureus Infections in Korea
Kyoung‐Ho Song, Eu Suk Kim, Kyung‐Hwa Park, Hee Jung Choi, Nak‐Hyun Kim, Shinwon Lee, Jeong‐Hwan Hwang, Eun Ju Choo, Yoonseon Park, Eun Jung Lee, Young Keun Kim, Min Hyok Jeon, Chisook Moon, Joo‐Hee Hwang, Jeong Su Park, Kyoung Un Park, Pyoeng Gyun Choe, Ji Hwan Bang, Myoung‐don Oh, Hong Bin Kim, and Korea INfectious Diseases (KIND) Study Group, Na-Ra Yoon, Dong‐Min Kim, Chang Seop Lee, Jae Hoon Lee, Kkot Sil Lee, Yee Gyung Kwak, Seong Yeon Park, Taek Soo Kim, Sue Shin, Eui-Chong Kim, Gayeon Kim, Shinhye Cheon, Nak‐Hyun Kim, Wan Beom Park, Nam Joong Kim, Sun Hee Lee, Ki Tae Kwon, Chisook Moon, Sang‐Won Park, Jongyoun Yi, Young Hwa Choi
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Abstract
AIM: Panton-Valentine leukocidin (PVL) is a virulent cytotoxin and an indicator of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. In this study, we evaluated the prevalence and clinical and molecular characteristics of PVL-positive invasive S. aureus (ISA) infections in Korea. RESULTS: A collection of 1,962 nonduplicate clinical isolates were screened for multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec), accessory gene regulator typing, major toxins, and antimicrobial susceptibility. Twenty-eight (1.4%) PVL-positive S. aureus samples were found; of them 19 (67.9%) were MRSA (8 CA and 11 healthcare-associated infections). Seventeen patients (60.7%) were men (median age: 63 years; range: 13-93 years) and 12 patients (42.9%) had no underlying comorbidities. The most common infections were skin and skin structure infection (SSSI) and pneumonia. The 30-day mortality rate was 37.0%. The most common PVL-positive MRSA clones were ST8-SCCmec IVa and ST30-SCCmec IVc along with their single-locus variants. Antimicrobial susceptibility and toxin-gene profile differed according to the clone. CONCLUSIONS: ISA infections caused by PVL-positive strains are rare in Korea, with the two most common infections being SSSI and pneumonia. Our findings indicated that several PVL-positive MRSA clones, predominantly ST8-SCCmecIVa and ST30-SCCmecIVc, were circulating and causing sporadic cases of ISA infections in the community and hospital settings.