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, Kye Hyung 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

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4 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)450-456
Number of pages7
JournalMicrobial Drug Resistance
Volume25
Issue number3
DOIs
Publication statusPublished - 2019 Apr

Bibliographical note

Funding Information:
This work was supported by a grant No. 03-2012-005 from Seoul National University Bundang Hospital (to E.S.K.). This study was presented as a poster in ASM Microbe, Boston, MA, 2016 (abstract No. MONDAY-381).The authors thank the members of the Korea INfectious Diseases (KIND) study group and the associated staff for their cooperation in this study. The collaborators in the KIND study group were Hee-Chang Jang and Sook-In Jung, Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Republic Korea; Nara Yoon and Dong-Min Kim, Department of Internal Medicine, Chosun University Hospital, Gwangju, Republic of Korea; Chang Seop Lee, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea; Jae Hoon Lee, Department of Internal Medicine, Wonkwang University Hospital, Iksan, Republic of Korea; Kkot Sil Lee, Department of Internal Medicine, Myongji Hospital, Goyang, Republic of Korea; Yee Gyung Kwak, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea; Seong Yeon Park, Department of Internal Medicine, Dongguk Uni- versity Ilsan Hospital, Goyang, Republic of Korea; Taek Soo Kim, Sue Shin, and Eui-Chong Kim, Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic Korea; Gayeon Kim, Shinhye Cheon, Nak-Hyun Kim, Wan Beom Park, and Nam-Joong Kim, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Sun Hee Lee, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea; Ki Tae Kwon, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea; Chisook Moon, Department of Internal Medicine, Inje University College of Medicine, Busan, Republic of Korea; Sang Won Park, Division of Infectious Diseases, Seoul Metropolitan Government—Seoul National University Boramae Medical Center, Seoul, Republic of Korea; Jongyoun Yi, Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea; Young Hwa Choi, Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea.

Publisher Copyright:
© 2019, Mary Ann Liebert, Inc., publishers.

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Immunology
  • Pharmacology
  • Microbiology (medical)

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