New strains of community-acquired methicillin-resistant Staphylococcus aureus with Panton-Valentine leukocidin causing an outbreak of severe soft tissue infection in a football team.

摘要: A new category of methicillin-resistant Staphylococcus aureus (MRSA), designated community-acquired MRSA (CA-MRSA), has been noted increasingly in the community past 14 years [1]. CA-MRSA strains have different genetic backgrounds than hospital-acquired MRSA, as evidenced by pulsed-field gel electrophoresis (PFGE) patterns, and thus do not descend from nosocomial strains. They also carry a novel staphylococcal cassette chromosome (SCC) mec type IV element, which is differentiated SCCmec types I-III its smaller size absence non-s-lactam resistance determinants. In addition, replicate more rapidly strains, they better ability to colonize humans, possess genes for toxins [2]. Major risk factors colonization, recognized Ellis et al. [3], are treatment with systemic antibiotics skin trauma. The producing Panton–Valentine leukocidin cause furunculosis severe necrotic hemorrhagic pneumonia otherwise healthy individuals [3, 4]. Outbreaks described day-care athletic settings. Sport teams especially vulnerable infections these because frequent trauma close contact team members [4]. order detect outbreaks CAMRSA, molecular typing [5–8] should be performed virulence detected [9]. Reported here an outbreak soft tissue infection affecting football team, was caused strain carrying gene. From July October 2004, consisting 26 (24 players, coach masseur, all male) affected severe, highly transmissible infection. diagnose investigate background involved we studied 246 specimens obtained members’ furuncles, nasal surveillance cultures postoperative wounds. Specimens were plated onto blood agar oxacillin screening base (ORSAB) medium. Isolates identified S. their growth yellow colonies, or without hemolysis on results Gram staining, catalase, DNase test tube coagulase test. Blue-colored colonies that appeared after 2 3 days incubation ORSABmedium suspected being possible MRSA. Susceptibility testing using Kirby–Bauer disk diffusion method, recommended Clinical Laboratory Standards Institute (formerly NCCLS) [10]. Methicillin determined 1 μg method confirmed plate (Mueller–Hinton containing 4% NaCl 6 μg/ml oxacillin), cefoxitin Etest methods. penicillin, erythromycin, clindamycin, trimethoprim/sulfamethoxazole, vancomycin, rifampin, gentamicin, ciprofloxacin, teicoplanin, linezolid, mupirocin fusidic acid determined. Oxacillin simultaneous detection M. Muller-Premru (*) . K. Seme N. Kucina V. Spik Gubina Microbiology Immunology, Medical Faculty, Zaloska 4, Ljubljana, Slovenia e-mail: manica.mueller-premru@mf.uni-lj.si Tel.: +386-1-5437425 Fax: +386-1-5437401