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      Pacemaker-associated infection caused by ST81/SCC mec IV methicillin-resistant, vancomycin-intermediate Staphylococcus aureus in Japan

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          Abstract

          A 76-year-old Japanese man was admitted to hospital for treatment of fever and skin lesion at the implantation site of his pacemaker. During his hospitalization, vancomycin-intermediate Staphylococcus aureus (MIC 4 μg/mL) with reduced susceptibility to daptomycin was isolated from venous blood. This isolate was identified as methicillin-resistant S. aureus with SCC mec IV and was genotyped as sequence type 81, coa VIIa and spa type t7044, harbouring blaZ, aac( 6′)- aph( 2″) and enterotoxin(-like) genes sea, seb, sek, sel, s elx and selw. The patient was successfully treated with daptomycin, minocycline and sulfamethoxazole/trimethoprim. We describe the identification of sequence type 81/SCC mec IV vancomycin-intermediate S. aureus from pacemaker-associated septicaemia.

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          Methicillin-resistant Staphylococcus aureus clinical strain with reduced vancomycin susceptibility.

          K Hiramatsu (1997)
          Article 0 comments Cited 235 times – based on 0 reviews     Review now
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            Staphylococcal cassette chromosome mec (SCCmec) typing of methicillin-resistant Staphylococcus aureus strains isolated in 11 Asian countries: a proposal for a new nomenclature for SCCmec elements.

            Piriyaporn Chongtrakool, Teruyo Ito, Xiao Xue Ma … (2006)
            A description of staphylococcal cassette chromosome mec (SCCmec) elements carried by 615 methicillin-resistant Staphylococcus aureus (MRSA) strains isolated in 11 Asian countries is reported, and a novel nomenclatural system based on their structures is proposed. The 615 strains were classified as type 3A (370 strains), type 2A (207 strains), type 2B (32 strains), type 1B (1 strain), and nontypeable (5 strains). The previously reported type III SCCmec (DDBJ/EMBL/GenBank accession no. AB037671) carried by the MRSA strain 85/2082 was ascertained to be composed of two SCC elements, type 3A SCCmec and SCCmercury. PCR analysis indicated that 310 of 370 type 3A SCCmec strains carried both SCC elements. These strains were prevalent in eight countries: Thailand, Sri Lanka, Indonesia, Vietnam, Philippines, Saudi Arabia, India, and Singapore. The remaining 60 type 3A SCCmec strains differed with respect to the left extremity polymorphism or to the presence of ccrC. Among these, two were identified as carrying only type 3A SCCmec elements, but their left extremities differed. Type 2A SCCmec strains predominated in Korea and Japan, although the frequency of the presence of ant(4')-1 gene downstream of mecA varied (53% for Korean strains; 93% for Japanese strains). Various SCCmec elements were identified in the tested strains, and limited numbers were identified by their multilocus sequence typing genotypes. These data suggest that numerous MRSA clones are disseminated in Asian hospitals, and these consist of minor clones that are presumed to have arisen locally and major clones that are presumed to have been introduced from other countries.
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              Genomic insights into the emergence and spread of international clones of healthcare-, community- and livestock-associated meticillin-resistant Staphylococcus aureus: Blurring of the traditional definitions.

              A M Bal, G W Coombs, M T G Holden … (2016)
              The evolution of meticillin-resistant Staphylococcus aureus (MRSA) from meticillin-susceptible S. aureus has been a result of the accumulation of genetic elements under selection pressure from antibiotics. The traditional classification of MRSA into healthcare-associated MRSA (HA-MRSA) and community-associated MRSA (CA-MRSA) is no longer relevant as there is significant overlap of identical clones between these groups, with an increasing recognition of human infection caused by livestock-associated MRSA (LA-MRSA). Genomic studies have enabled us to model the epidemiology of MRSA along these lines. In this review, we discuss the clinical relevance of genomic studies, particularly whole-genome sequencing, in the investigation of outbreaks. We also discuss the blurring of each of the three epidemiological groups (HA-MRSA, CA-MRSA and LA-MRSA), demonstrating the limited relevance of this classification.
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                Author and article information

                Contributors
                N. Kobayashi
                Journal
                Journal ID (nlm-ta): New Microbes New Infect
                Journal ID (iso-abbrev): New Microbes New Infect
                Title: New Microbes and New Infections
                Publisher: Elsevier
                ISSN (Print): 2052-2975
                ISSN (Electronic): 2052-2975
                Publication date PMC-release: 14 February 2020
                Publication date Collection: May 2020
                Publication date (Electronic): 14 February 2020
                Volume: 35
                Electronic Location Identifier: 100656
                Affiliations
                [1) ]Department of Pharmacy, Sapporo Medical University School of Medicine, Sapporo, Japan
                [2) ]Department of Laboratory, Sapporo Medical University School of Medicine, Sapporo, Japan
                [3) ]Department of Paediatrics, Hakodate Municipal Hospital, Hakodate, Japan
                [4) ]Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan
                Author notes
                [∗ ] Corresponding author: N. Kobayashi, Department of Hygiene, Sapporo Medical University School of Medicine, S-1 W-17, Chuo-ku, Sapporo, 060-8556, Japan. nkobayas@ 123456sapmed.ac.jp
                Article
                Publisher ID: S2052-2975(20)30008-1 Publisher ID: 100656
                DOI: 10.1016/j.nmni.2020.100656
                PMC ID: 7083773
                SO-VID: f3c0644c-b23b-49eb-8779-c6bbec47e1f3
                Copyright © © 2020 The Author(s)
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 9 December 2019
                Date revision received : 20 January 2020
                Date accepted : 10 February 2020
                Categories
                Subject: New Resistant Microbes in Human

                Keywords: japan,mrsa,pacemaker-associated infection,st81,vancomycin-intermediate staphylococcus aureus(visa)
                Data availability:
                Keywords: japan, mrsa, pacemaker-associated infection, st81, vancomycin-intermediate staphylococcus aureus(visa)

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