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Journal of Clinical Microbiology, April 2009, p. 940-945, Vol. 47, No. 4
0095-1137/09/$08.00+0     doi:10.1128/JCM.02352-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Presence and Molecular Epidemiology of Virulence Factors in Methicillin-Resistant Staphylococcus aureus Strains Colonizing and Infecting Soldiers{triangledown}

Michael W. Ellis,1,{dagger}* Matthew E. Griffith,1 James H. Jorgensen,2 Duane R. Hospenthal,1 Katrin Mende,3 and Jan E. Patterson2,4,5

Department of Medicine (Infectious Diseases), Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas,1 Departments of Pathology,2 Medicine (Infectious Diseases), University of Texas Health Science Center, San Antonio, Texas,4 Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland,3 South Texas Veterans Health Care System, San Antonio, Texas5

Received 8 December 2008/ Returned for modification 19 January 2009/ Accepted 4 February 2009

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important cause of skin and soft-tissue infections (SSTI). The understanding of the molecular epidemiology and virulence of MRSA continues to expand. From January 2005 to December 2005, we screened soldiers for MRSA nasal colonization, administered a demographic questionnaire, and monitored them prospectively for SSTI. All MRSA isolates underwent molecular analysis, which included pulsed-filed gel electrophoresis (PFGE) and PCR for Panton-Valentine leukocidin (PVL), the arginine catabolic mobile element (ACME), and the staphylococcal cassette chromosome mec (SCCmec). Of the 3,447 soldiers screened, 134 (3.9%) had MRSA colonization. Of the 3,066 (89%) who completed the study, 39 developed culture-confirmed MRSA abscesses. Clone USA300 represented 53% of colonizing isolates but was responsible for 97% of the abscesses (P < 0.001). Unlike colonizing isolates, isolates positive for USA300, PVL, ACME, and type IV SCCmec were significantly associated with MRSA abscess isolates. As determined by multivariate analysis, risk factors for MRSA colonization were a history of SSTI and a history of hospitalization. Although various MRSA strains may colonize soldiers, USA300 is the most virulent when evaluated prospectively, and PVL, ACME, and type IV SCCmec are associated with these abscesses.

* Corresponding author. Mailing address: Uniformed Services University of the Health Sciences, Department of Medicine (Infectious Diseases), 4301 Jones Bridge Road, Bethesda, MD 20814. Phone: (301) 295-3619. Fax: (301) 295-3557. E-mail: michael.w.ellis{at}us.army.mil

{triangledown} Published ahead of print on 11 February 2009.

{dagger} Present address: Department of Medicine (Infectious Diseases), Uniformed Services University of the Health Sciences, Bethesda, MD 20814.

Journal of Clinical Microbiology, April 2009, p. 940-945, Vol. 47, No. 4
0095-1137/09/$08.00+0     doi:10.1128/JCM.02352-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Tenover, F. C., Goering, R. V. (2009). Methicillin-resistant Staphylococcus aureus strain USA300: origin and epidemiology. J Antimicrob Chemother 64: 441-446 [Abstract] [Full Text]  


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