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Journal of Clinical Microbiology, September 2005, p. 4719-4730, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4719-4730.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Successful Multiresistant Community-Associated Methicillin-Resistant Staphylococcus aureus Lineage from Taipei, Taiwan, That Carries Either the Novel Staphylococcal Chromosome Cassette mec (SCCmec) Type VT or SCCmec Type IV

Susan Boyle-Vavra,1* Ben Ereshefsky,1 Chih-Chien Wang,2 and Robert S. Daum1

Department of Pediatrics, Section of infectious Diseases, University of Chicago, Chicago, Illinois,1 Department of Pediatrics, Tri-Services General Hospital, National Defense Medical Center, Taipei, Taiwan2

Received 11 February 2005/ Returned for modification 27 March 2005/ Accepted 22 May 2005

Methicillin-resistant Staphylococcus aureus (MRSA) isolates carry the methicillin resistance gene (mecA) on a horizontally transferred genetic element called the staphylococcal chromosome cassette mec (SCCmec). Community-acquired MRSA (CAMRSA) isolates usually carry SCCmec type IV. We previously reported that 76% of 17 CAMRSA isolates (multilocus sequence type 59) obtained from pediatric patients with skin and soft tissue infections (SSTI) from Taipei did not carry SCCmec types I to IV. We used DNA sequence analysis to determine that the element harbored by these nontypeable isolates is a novel subtype of SCCmec V called SCCmec VT. It contains a ccrC recombinase gene variant (ccrC2) and mec complex C2. One SSTI isolate contained molecular features of SCCmec IV but also contained ccrC2 (a feature of SCCmec VT), suggesting that it may harbor a composite SCCmec element. The genes lukS-PV and lukF-PV encoding the Panton-Valentine leukocidin (PVL) were present in all CAMRSA SSTI isolates whether they contained SCCmec type IV or VT. SCCmec VT was also present in 5 of 34 (14.7%) CAMRSA colonization isolates collected from healthy children from Taipei who lacked MRSA risk factors. Four (80%) of the these isolates contained lukS-PV and lukF-PV, as did 1 of 27 (3.7%) SCCmec IV-containing colonization isolates. A total of 63% (10 of 16) of the SSTI isolates and 61.7% (21 of 34) of the colonization isolates tested were resistant to at least four classes of non-ß-lactam antimicrobials. SCCmec VT is a novel SCCmec variant that is found in multiply resistant CAMRSA strains with sequence type 59 in Taipei in association with the PVL leukotoxin genes.

* Corresponding author. Mailing address: University of Chicago, MC6054, 5841 S. Maryland Ave., Chicago, IL, 60637. Phone: (773) 702-6176. Fax: (773) 702-1196. E-mail: sboyle{at}peds.bsd.uchicago.edu.

Journal of Clinical Microbiology, September 2005, p. 4719-4730, Vol. 43, No. 9
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.9.4719-4730.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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