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Journal of Clinical Microbiology, March 2008, p. 991-995, Vol. 46, No. 3
0095-1137/08/$08.00+0     doi:10.1128/JCM.00698-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Epidemiological Characteristics of Methicillin-Resistant Staphylococcus aureus Isolates from Children with Eczematous Atopic Dermatitis Lesions{triangledown}

Hee-Jung Chung,1 Hong-Seon Jeon,1 Heungsup Sung,1 Mi-Na Kim,1* and Soo-Jong Hong2

Department of Laboratory Medicine Department of Pediatrics, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

Received 30 March 2007/ Returned for modification 6 July 2007/ Accepted 24 December 2007

In this study, we investigated the rate of colonization of skin of children with atopic dermatitis (AD) by methicillin-resistant Staphylococcus aureus (MRSA) and characterized the isolates. Active skin lesions in pediatric AD patients were cultured with Rodac Staph (Komed, Korea). S. aureus isolates were examined for drug susceptibilities, analyzed for the eta, etb, tst, and pvl genes, and typed using agr polymorphism, pulsed-field gel electrophoresis of SmaI-restricted chromosomal DNA, and staphylococcal cassette chromosome mec (SCCmec) typing. Eighty-seven (75.4%) of 115 patients had cultivable S. aureus isolates, 16 of which (18.3%) were MRSA. All MRSA isolates were susceptible to chloramphenicol, rifampin, cotrimoxazole, and ciprofloxacin. While methicillin-susceptible S. aureus (MSSA) isolates were composed of 23 isolates of singular types and nine clusters comprising 48 isolates, MRSA isolates were typed into three clones: eight isolates of pulsotype A-agr-1-SCCmec IV, five isolates of pulsotype B-agr-3-SCCmec IIb-etb positive, and three isolates of pulsotype C-agr-3-SCCmec IV. Three SCCmec IVA MRSA isolates were tst positive, but none were positive for the pvl or eta gene. Among 71 MSSA isolates, 7 isolates were tst positive, 6 of which were pulsotype F-agr-3, and 9 of 10 agr-4 isolates were eta positive. The average ages of patients carrying MSSA, SCCmec IVA MRSA, and SCCmec IIb MRSA were 7.7 ± 4.6, 3.1 ± 1.5, and 8.2 ± 3.1 years, respectively. Among the patients carrying MRSA, two patients had been treated with oral antimicrobials, and one had been admitted to the hospital 18 months previously. In conclusion, community-acquired MRSA isolates of a few clones colonized the skin of patients with AD without risk factors for the acquisition of hospital-acquired MRSA, which suggested that the skin of children with AD may represent a significant reservoir of MRSA colonization in the community.

* Corresponding author. Mailing address: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. Phone: 82-2-3010-4511. Fax: 82-2-478-0884. E-mail: mnkim{at}amc.seoul.kr

{triangledown} Published ahead of print on 3 January 2008.

Journal of Clinical Microbiology, March 2008, p. 991-995, Vol. 46, No. 3
0095-1137/08/$08.00+0     doi:10.1128/JCM.00698-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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