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Journal of Clinical Microbiology, July 2005, p. 3364-3372, Vol. 43, No. 7
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.7.3364-3372.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Dissemination of Methicillin-Resistant Staphylococci among Healthy Japanese Children

Ken Hisata,1,2 Kyoko Kuwahara-Arai,1 Munetaka Yamanoto,1,3 Teruyo Ito,1 Yasuo Nakatomi,4 Longzhu Cui,1 Tadashi Baba,1 Masahiko Terasawa,5 Chie Sotozono,6 Shigeru Kinoshita,6 Yuichiro Yamashiro,2 and Keiichi Hiramatsu1*

Department of Bacteriology, School of Medicine, Juntendo University, Tokyo, Japan,1 Department of Pediatrics, School of Medicine, Juntendo University, Tokyo, Japan,2 Department of Neurosurgery, School of Medicine, Juntendo University, Tokyo, Japan,3 Denka Seiken Co., Ltd., Tokyo, Japan,4 Terasawa Children's Clinic, Sendai-City, Miyagi, Japan,5 Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan6

Received 28 December 2004/ Returned for modification 15 February 2005/ Accepted 8 March 2005

Methicillin-resistant Staphylococcus aureus (MRSA), regarded as a tenacious pathogen in the hospital, has recently become increasingly prevalent as a community pathogen. We evaluated the prevalence and characteristics of methicillin-resistant staphylococci in the Japanese community by testing nasal samples of 818 children of five day care centers and two kindergartens in three districts. We found that methicillin-resistant staphylococci are already prevalent among healthy children. Among 818 children, 35 children (4.3%) carried MRSA and 231 children (28.2%) carried methicillin-resistant coagulase-negative staphylococci (MRC-NS). The types of staphylococcal cassette chromosome mec (SCCmec) found among 44 MRSA isolates were as follows: type IIa, 11 isolates; type IIb, 19 isolates; and type IV, 14 isolates. The type IIb SCCmec element was a new SCCmec element found in this study. Eleven (25%) strains which belonged to clonal complex 5 (CC5) carried type IIa SCCmec, and they produced type 2 coagulase and toxic shock syndrome toxin 1. They were indistinguishable from health care-associated MRSA (H-MRSA) strains in Japan, represented by strain N315. On the other hand, 33 (75%) strains, most of which belonged to CC78 or CC91, carried small SCCmec elements, such as type IIb or type IV, and they produced type 1 or type 3 coagulase and exfoliative toxin. The data indicated that MRSA clones distinct from H-MRSA have disseminated in healthy children. The fact that MRC-NS strains were prevalent in the community suggested that they might serve as a reservoir for the SCCmec element carried by MRSA strains disseminated in the community.

* Corresponding author. Mailing address: Department of Bacteriology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Phone: 81-3-5802-1040. Fax: 81-3-5684-7830. E-mail: hiram{at}med.juntendo.ac.jp.

Journal of Clinical Microbiology, July 2005, p. 3364-3372, Vol. 43, No. 7
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.7.3364-3372.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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