Clonal Association of Staphylococcus aureus Causing Bullous Impetigo and the Emergence of New Methicillin-Resistant Clonal Groups in Kansai District in Japan

• Published in: The Journal of infectious diseases Vol. 185; no. 10; pp. 1511 - 1516
• Main Authors: Yamaguchi, Takayuki, Yokota, Yoshiko, Terajima, Jun, Hayashi, Tetsuya, Aepfelbacher, Martin, Ohara, Masaru, Komatsuzawa, Hitoshi, Watanabe, Haruo, Sugai, Motoyuki
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.05.2002; University of Chicago Press; Oxford University Press
• Subjects: Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial diseases; Biological and medical sciences; Blister - epidemiology; Concise Communications; DNA; DNA, Bacterial - genetics; Enterotoxins; Gels; Hospitals; Human bacterial diseases; Humans; Impetigo; Impetigo - epidemiology; Infectious diseases; Japan - epidemiology; Medical sciences; Methicillin - pharmacology; Methicillin Resistance - genetics; Microbial Sensitivity Tests; Outpatients; Penicillins - pharmacology; Pharmacology. Drug treatments; Polymerase chain reaction; Polymorphism, Restriction Fragment Length; Skin; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcal scalded skin syndrome; Staphylococcus aureus; Staphylococcus aureus - drug effects; Staphylococcus aureus - genetics; Toxins; Asia; Japan; Human; Staphylococcal scalded skin syndrome; β-Lactams; Meticillin; Infection; Penicillin derivatives; Resistance; Toxin; Pulsed field electrophoresis; Sensitivity; Treatment; Gene; Impetigo; Bacteriosis; Bacteria; Micrococcales; Isolate; Micrococcaceae; Skin; Staphylococcal infection; Staphylococcus aureus
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/340212

A molecular epidemiological analysis was performed to reveal the clonal association of Staphylococcus aureus strains isolated from patients with bullous impetigo. Pulsed-field gel electrophoresis with cluster analysis, genetic and phenotypic characterizations, and antimicrobial susceptibility profiling of 88 S. aureus strains isolated from outpatients at 4 hospitals in the Kansai district in Japan were undertaken. Three distinct clonal groups were identified: 2 of them carried the exfoliative toxin (ET) A gene (eta), and the other carried the ETB gene (etb). The former groups represent 2 eta-positive clonal groups that have not been described previously. All the strains in the more dominant eta-positive clonal group and some of the strains in the etb-positive clonal group were methicillin-resistant S. aureus (MRSA) showing borderline-to-moderate resistance to β-lactams. These MRSA strains appear to be emerging clonal groups that have not been considered in previous epidemiological studies of ET-producing S. aureus in Japan and thus pose a significant threat for future treatment of patients with bullous impetigo and/or staphylococcal scaldedskin syndrome.