Evolution and virulence of Panton-Valentine leukocidin-positive ST30 methicillin-resistant Staphylococcus aureus in the past 30 years in Japan

Biomed Res. 2012 Apr;33(2):97-109. doi: 10.2220/biomedres.33.97.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) includes hospital-acquired MRSA (HAMRSA) and community-acquired MRSA (CA-MRSA). Panton-Valentine leukocidin (PVL)-positive multilocus sequence type 30 (ST30) MRSA is one of worldwide CA-MRSA, which has also persisted in Japan since the 1980s. However, unexpectedly, it was not the same ST30 clone throughout. Before 2000, it was HA-MRSA with spa43 and ψSa3sea (phage Sa3 carrying the sea gene) and only one PVL-positive MRSA in Japan; in the 1980s, ST30 MRSA accounted for 23.5% of HA-MRSA, showed multidrug resistance, had high MICs for oxacillin and imipenem, and caused decubitus and pneumonia in hospitalized patients. A dynamic clonal change (spa43/ψSa3sea→ spa19) occurred around 2000-2002. A rare spa43/ψSa3sea/SCCmecI-IE25923 genotype also emerged. After 2002, the prevalent spa19 clone was CA-MRSA; it accounted for only 0.3% (or less) of MRSA in hospitals but 7.6% of CA-MRSA. Since 2007, PVL-positive CA-MRSA with other ST types (such as ST8, ST22, and ST59) also emerged in Japan, albeit at a low frequency. ST30/spa19 CA-MRSA occasionally caused severe invasive infections and a novel ST1335/spa19 genotype emerged. These ST30/spa19 CA-MRSA and variants were identified by pulsed field gel electrophoresis. Further analysis revealed that PVL-positive ST30/spa19 CA-MRSA is a highlyvirulent, successful clone, having a potential of clonal expansion.

Publication types

  • Historical Article

MeSH terms

  • Adolescent
  • Adult
  • Bacterial Toxins / genetics*
  • Cell Line
  • Child
  • Child, Preschool
  • Drug Resistance, Multiple, Bacterial
  • Electrophoresis, Gel, Pulsed-Field
  • Evolution, Molecular*
  • Exotoxins / genetics*
  • Female
  • Genes, Bacterial
  • Genetic Linkage
  • History, 20th Century
  • History, 21st Century
  • Host-Pathogen Interactions
  • Humans
  • Infant
  • Leukocidins / genetics*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / genetics*
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity
  • Middle Aged
  • Phenotype
  • Phylogeny
  • Staphylococcal Infections / history
  • Staphylococcal Infections / microbiology*
  • Transcription, Genetic
  • Virulence / genetics

Substances

  • Bacterial Toxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin