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Journal of Clinical Microbiology, May 2004, p. 2080-2084, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.2080-2084.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Widespread Skin and Soft-Tissue Infections Due to Two Methicillin-Resistant Staphylococcus aureus Strains Harboring the Genes for Panton-Valentine Leucocidin

Binh An Diep,1,2 George F. Sensabaugh,1 Naraporn S. Somboona,1 Heather A. Carleton,2 and Françoise Perdreau-Remington2*

Division of Infectious Diseases, School of Public Health, University of California, Berkeley, California 94720,1 Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, California 941102

Received 28 November 2003/ Returned for modification 27 January 2004/ Accepted 11 February 2004

Infections caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging as a major public health problem. CA-MRSA has been associated previously with skin and soft-tissue infection (SSTI) and with carriage of staphylococcal cassette chromosome mec (SCCmec) type IV and the Panton-Valentine leucocidin (PVL) virulence factor. To assess the clonal distribution of PVL-carrying strains and the association with SSTI in the San Francisco Bay area, we surveyed six collections of S. aureus isolates—671 isolates in all—collected between 1997 and 2002 originating from inpatient and outpatient clinical specimens and from a community-based sampling. Isolates were genotyped by pulsed-field gel electrophoresis, multilocus restriction fragment typing, and multilocus sequence typing and assayed for the PVL virulence factor. The S. aureus populations showed a high proportion of PVL-carrying strains, with frequencies ranging up to 70% in MRSA isolated from jail inmate patients and 69% in MRSA from patients receiving surgical treatment at an outpatient clinic specializing in treating SSTIs. PVL-carrying isolates were identified in nine clonal groups, but 88.5% of the PVL-carrying MRSA isolates belonged to only two clonal groups. These two clonal groups carried the SCCmec type IV resistance determinant and were more likely than other clonal groups to be recovered from SSTI sites than from other sites (P < 0.0001). There is evidence of clonal replacement over the period from 1999 to 2002, with one of these two clonal groups being supplanted by the other.

* Corresponding author. Mailing address: Dept. of Medicine, University of California, San Francisco, Division of Infectious Diseases, San Francisco General Hospital, 1001 Potrero Ave., UCSF 1372, Building 100, Room 301, San Francisco, CA 94110. Phone: (415) 206-6899. Fax: (415) 206-4360. E-mail: fpr{at}epi-center.ucsf.edu.

Journal of Clinical Microbiology, May 2004, p. 2080-2084, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.2080-2084.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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