• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.50-53
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• 2018

Staphylococcus aureus is a well-recognized human pathogen that causes a wide range of infections as a result of its extensive virulence factors. One of these factors is Panton-Valentine leukocidin (PVL), a potent pore-forming cytotoxin that has been linked to invasive S. aureus infections. PVL is one of the important virulence factors for S. aureus and has been largely recognized as one of the markers for community-acquired methicillin-resistant S. aureus. However, the presence of PVL in methicillin-susceptible S. aureus infections is not widely reported in the literature. Thrombotic sequelae of S. aureus infections associated with PVL expression are uncommon in children. We hereby report two children with thrombotic complications associated with PVL-producing methicillin-susceptible S. aureus. Both patients responded well to antibiotic and anticoagulant therapies, and survived without any long-term sequelae.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.107-112
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• 2018

Staphylococcus aureus is now a major community-acquired pathogen worldwide, notably associated with skin and soft tissue infections. Staphylococci are present in the form of colonizers or environmental contaminants at home and increase the risk of recurrent infection. We are describing recurrent familial furunculosis caused by Panton-Valentine Leukocidin-positive methicillin susceptible S. aureus ST1 in Korea. An infant, his father and mother had furunculosis due to methicillin-sensitive S. aureus (MSSA) infection with identical susceptibility patterns. ST1 accounted for all 3 isolates and they were confirmed of having agr group I. Both sec and seh were detected in all isolates using polymerase chain reaction (PCR) assays, and all isolates contained Panton-Valentine leukocidin (PVL) genes. Risk factors for the household spread of S. aureus include skin conditions and close physical contact among household members. The relationship between S. aureus colonization of household contacts and the occurrence of S. aureus infection should be studied into more detail.

• Pediatric Infection and Vaccine
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• v.30 no.3
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• pp.152-158
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• 2023

Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

• Journal of Life Science
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• v.21 no.2
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• pp.257-264
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• 2011

Seventy five methicillin- resistant Staphylococcus aureus (MRSA) strains and 24 methicillin- susceptible S. aureus (MSSA) were isolated from clinical specimens obtained from a hospital in Suncheon, Jeonnam province, Korea, from July to December, 2009. Antibiotic resistance was determined using the disc diffusion method. Genes encoding enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), exfoliative toxin (ET) and Panton-Valentine leukocidin (PVL) were detected by multiplex PCR-mediated amplification using specific primers. Sixty (80%) MRSA isolates possessed either one or more toxin genes and the most common pattern that coexisted in MRSA was seb, sec, seg, sei and tst (22.7%) followed by coexistence of sec, seg, sei and tst genes (18.7%). Gene pvl encoding leukocidin was not found. Significant correlation between the production of sec, seg, sei and tst genes was found. MRSAs were resistant to erythromycin (89% of the isolates), gentamicin (70.7%), ciprofloxacin (69.3%), clindamycin (61.3%) and tetracycline (58.7%), while MSSAs were susceptible to the antibiotics with the exception of erythromycin. Toxin genes seb, sec and tst were related to the tetracycline resistance of MRSA.

• Journal of Food Hygiene and Safety
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• v.29 no.3
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• pp.223-227
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• 2014

This study was investigated to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) isolated from raw milk samples and to further study on the molecular characteristics of the MRSA isolates. Using Staphylococcus Medium 110, Staphylococcus spp. were isolated from raw milk samples and further identification was carried by Vitek2 system. Minimum inhibitory concentrations (MICs) of antibiotics were conducted by serial dilution method according to the Clinical Laboratory Standards Institute (CLSI) guideline. For the detection of resistance genes and molecular characterization, PCR reaction was performed by gene specific primers and followed by DNA sequencing. Of the 698 milk samples, 94 Staphylococcus aureus (S. aureus) were identified (94 S. aureus/286 Staphylococcus spp.). Of the 94 S. aureus, seven isolates have mecA, a methicillin resistant gene. mecA positive seven isolates were then characterized by staphylococcal cassette chromosome mec (SCCmec) typing, and Panton-Valentine Leukocidin (pvl) gene using PCR. All of mecA positive isolates were resistant to ampicillin and oxacillin, but sensitive to teicoplanin, vancomycin and ciprofloxacin. One of seven isolates was SCCmec type II and six isolates were type IV and all seven isolates were pvl gene negative.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.3
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• pp.202-209
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• 2016

This study is aimed to determine the correlation between the toxin gene types and antibiotic resistance from MRSA (methicillin-resistant Staphylococcus aureus). Fifty-two strains of MRSA, between January 2014, and December 2014, were isolated from clinical specimens obtained from 2,664 cases in the intensive care unit of a hospital in Suncheon, Jeonnam, Korea. Genes encoding mecA, enterotoxin (SE), toxic shock syndrome toxin-1 (TSST-1), exfoliative toxin (ET), and Panton-Valentine leukocidin (PVL) were detected by multiplex PCR-mediated amplification using specific primers. Toxin genes (seg and sei) were present in 40 strains (76.9%), followed by tst in 34 strains (65.4%). Other genes (eta, etb, sea, sed, see, seh, sej, and pvl) were not detected. Forty strains (76.9%) of MRSA had 2 or more toxin genes simultaneously; 5 coexistent toxin-genes (seb, sec, seg, sei, tst) were the most common in 28 strains (53.8%), and 6 strains (11.5%) had seg and sei genes. The coexistence of genes were 72.5~100%, showing a high correlation among genes (seb, sec, seg, sei and tst). As strains (seb, sec, tst) that had particular toxin genes (seb, sec, seg, sei, tst) in multiple showed 100% resistance to ciprofloxacin, clindamycin, erythromycin, we were able to find that seb, sec, and tst genes have a close relationship to the aforementioned antibiotics. It showed a higher resistance to ciprofloxacin, clindamycin, erythromycin, and tetracycline compared with strains that had toxin genes independent from multiple toxin genes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3315-3322
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• 2015

Staphylococcus aureus is the major causative organism of nasocomial infection being the important pathogen in the clinic. Appearance of staphylococcus aureus resistant to methicillin (MRSA) is becoming a big problem in clinics and dynamics all over the world acquiring antibiotic resistance with virulence factors as its feature differentiated from other pathogenic bacteria fast. This research intended to compare and analyze the correlation of antibiotics resistance between strains with toxin genes and distribution of toxin genes of MRSA 101 strains acquired from clinical specimen in one general hospital (enterotoxin(se), toxic shock syndrome toxin-1(tst), exfoliative toxin(et), Panton Valentine leukocidin(pvl)). seg gene, isolated the most among toxin genes, was detected in 59 strains (58.4%) and more than two toxin genes were detected in 70 strains (69.3%). As a combination possessing toxin genes, it was detected in 19 strains (18.8%) as seb, sec, seg, sei, tst and the second frequent combination was sec, seg, sei shown in 11 strains (10.9%). 19 strains (18.8%) with combinations of toxin genes same with seb, sec, seg, sei, tst had 100% resistance Ampicillin, Benzylpenicillin, Ciprofloxacin, Clindamycin, Gentamicin, Erythromycin, Telithromycin, Tetracycline antibiotics. Strains with many toxin genes showed high correlation of antibiotic resistance. Afterwards, effective therapy and thorough infection management should be preceded not to spread the resistance of MRSA strain.

• Journal of Microbiology and Biotechnology
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• v.19 no.10
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• pp.1265-1270
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• 2009

The objectives of this study were to determine the antibiotypes, SCCmec subtypes, PVL carriage, and genetic diversity of MRSA strains from a tertiary hospital. Sixty-six MRSA strains were selected randomly (2003, 2004, and 2007) and tested for the Panton-Valentine leukocidin gene, mecA gene, and SCCmec type via a PCR. The antibiograms were determined using a standard disc diffusion method, and the genetic diversity of the isolates was determined by PFGE. Thirty-four antibiograms were obtained, with 55% of the 66 strains exhibiting resistance to more than 4 antimicrobials. All the isolates remained susceptible to vancomycin, and low resistance rates were noted for fusidic acid (11%), rifampicin (11%), and clindamycin acid (19%). The MRSA isolates that were multisensitive (n=12) were SCCmec type IV, whereas the rest (multiresistant) were SCCmec type III. Only two isolates (SCCmec type IV) tested positive for PVL, whereas all the isolates were mecA-positive. The PFGE was very discriminative and subtyped the 66 isolates into 55 pulsotypes (F=0.31-1.0). The multisensitive isolates were distinctly different from the multidrug-resistant MRSA. In conclusion, no vancomycin-resistant isolate was observed. The Malaysian MDR MRSA isolates were mostly SCCmec type III and negative for PVL. These strains were genetically distinct from the SCCmec type IV strains, which were sensitive to SXT, tetracycline, and erythromycin. Only two strains were SCCmec IV and PVL-positive. The infections in the hospital concerned were probably caused by multiple subtypes of MRSA.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.62-66
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• 2016

Skin and soft tissue infections (SSTIs) caused by community-associated (CA)-methicillin-resistant Staphylococcus aureus (MRSA) have become a worldwide concern. An otherwise healthy 16-month-old Korean girl was admitted because of skin abscess on the left chest wall with a history of recurrent SSTIs since the age of 6 months. Immunologic evaluation including serum immunoglobulin level and nitroblue-tetrazolium (NBT) test were normal. Pus and nasal swab cultures revealed CA-MRSA ST714-SCCmec type IV with the Panton-Valentine leukocidin (PVL) genes, which was initially reported in the Netherlands in 2006 and has not been previously reported in Korea. The skin abscesses were successfully treated by needle aspiration and the use of antibiotics. In addition, nasal mupirocin was applied as a decolonization method. No more episodes of SSTI were observed over a follow-up period of 10 months.

• Tuberculosis and Respiratory Diseases
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• v.75 no.2
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• pp.75-78
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• 2013

Methcillin-resistant Staphylococcus aureus (MRSA) has emerged as an important cause of community-acquired infections, which has been recently designated as community-associated (CA) MRSA. Panton-Valentine leukocidin (PVL)-negative multilocus sequence type 72 (ST72)-staphylococcal cassette chromosome mec (SCCmec) type IV has been reported as the predominat CA-MRSA strain in Korea and is commonly associated with skin and soft tissue infections in addition to healthcare-associated pneumonia. However, community-acquired pneumonia (CAP) for this strain has not yet been reported. We hereby report two cases of CAP caused by PVL-negative ST72-SCCmec type IV strain in patients who had no risk factors for MRSA acquisition. While CA-MRSA infections are not yet prevalent in Korea, our cases suggest that CA-MRSA should be considered in cases of severe CAP, especially for cases associated with necrotizing pneumonia.