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Epidemiology

Pediatric Staphylococcus aureus Isolate Genotypes and Infections from the Dawn of the Community-Associated Methicillin-Resistant S. aureus Epidemic Era in Chicago, 1994 to 1997

Michael Z. David, Mary Ellen Acree, Julia J. Sieth, Dave J. Boxrud, Ginette Dobbins, Ruth Lynfield, Susan Boyle-Vavra, Robert S. Daum
C.-A. D. Burnham, Editor
Michael Z. David
aDepartment of Medicine, University of Chicago, Chicago, Illinois, USA
bDepartment of Pediatrics, University of Chicago, Chicago, Illinois, USA
cDepartment of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
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Mary Ellen Acree
bDepartment of Pediatrics, University of Chicago, Chicago, Illinois, USA
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Julia J. Sieth
bDepartment of Pediatrics, University of Chicago, Chicago, Illinois, USA
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Dave J. Boxrud
dMinnesota Department of Health, St. Paul, Minnesota, USA
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Ginette Dobbins
dMinnesota Department of Health, St. Paul, Minnesota, USA
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Ruth Lynfield
dMinnesota Department of Health, St. Paul, Minnesota, USA
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Susan Boyle-Vavra
bDepartment of Pediatrics, University of Chicago, Chicago, Illinois, USA
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Robert S. Daum
bDepartment of Pediatrics, University of Chicago, Chicago, Illinois, USA
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C.-A. D. Burnham
Roles: Editor
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DOI: 10.1128/JCM.00096-15
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    FIG 1

    Dendrogram showing the PFGE gel result for the sole USA300 MRSA isolate obtained in this study (isolate 111395F, which belonged to ST8, carried SCCmec type II, did not carry the PVL gene or arcA, and had spa type t064) as well as those for control USA300 and USA500 strains.

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  • TABLE 1

    Molecular characterization of 75 methicillin-susceptible Staphylococcus aureus isolates, University of Chicago Medical Center, 1995 to 1997a

    MLSTTotal no. of isolates (%)PVLYr of isolationNo. of isolates
    12 (2.7)−19961
    +19961
    510 (13.3)−19952
    −19967
    −19971
    84 (5.3)−19963
    −19951
    1512 (16)−19952
    −19967
    −19973
    253 (4)−19951
    −19961
    −19971
    3016 (21.3)−19952
    −19967
    −19976
    +19961
    391 (1.3)−19961
    4513 (17.3)−19953
    −19969
    −19971
    511 (1.3)−19961
    594 (5.3)−19951
    −19963
    961 (1.3)−19971
    1011 (1.3)−19961
    1093 (4)−19962
    −19951
    1211 (1.3)+19951
    4351 (1.3)−19961
    4741 (1.3)−19961
    5081 (1.3)−19951
    Total75 (100)75
    • ↵a All isolates were negative for opp3 and arcA, markers for the arginine catabolic mobile element (ACME), by PCR. MLST, multilocus sequence typing; PVL, Panton-Valentine leukocidin.

  • TABLE 2

    Molecular characterization of 30 methicillin-resistant Staphylococcus aureus isolates, University of Chicago Medical Center, 1994 to 1997a

    PFGE type (80% similarity cutoff)bTotal no. of isolates (%)MLSTSCCmec typePresence of geneYr of acquisitionspa typecNo. of isolates
    PVLarcAopp3
    NT2 (6.7)8IV+−−1997NA1
    12IV−−−1997NA1
    USA1002 (6.7)5II−−−1995NA1
    5II−−−1997NA1
    USA2003 (10.0)5II−−−1994NA1
    5II−−−1995NA1
    36II−−−1996NA1
    USA3001 (3.3)8II−−−1995t0641
    USA40013 (43.3)1IV+−−1996NA3
    1IV+−−1997NA5
    1IV−−−1995NA2
    1IV−−−1997NA1
    8IV+−−1997NA1
    8IV−−−1994NA1
    USA5008 (26.7)8IV+−−1996t0646
    8IV+−−1997t0642
    USA6001 (3.3)45IV−−−1997NA1
    Total30 (100)30
    • ↵a PFGE, pulsed-field gel electrophoresis; MLST, multilocus sequence typing; PVL, Panton-Valentine leukocidin; arcA and opp3, markers for the arginine catabolic mobile element (ACME) detected by PCR.

    • ↵b The isolates fell within the standard criteria used for inclusion in the USA typing scheme (at least 80% similarity to the pattern of a particular USA type). NT, nontypeable; the isolate(s) indicated did not fall into one of the known USA type clonal groups. All isolates showed banding patterns by PFGE. If an isolate had >80% pattern similarity with multiple USA types, the USA type that had the highest percentage of similarity was designated as the type.

    • ↵c Only USA300 and USA500 isolates were genotyped using spa typing. NA, not applicable (testing was not conducted).

  • TABLE 3

    Demographic and clinical characteristics of patients with methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus infections at the University of Chicago Medical Center, 1994 to 1997

    CharacteristicNo. (%) of patients with:P
    MRSA (n = 30)MSSA (n = 75)
    Clinical syndrome0.5
        Bacteremia, endocarditis, or sepsis8 (27)14 (19)
        Osteomyelitis or septic arthritis04 (5)
        Respiratory3 (10)2 (3)
        Skin and soft tissue infection16 (53)36 (48)
        Urinary tract infection01 (1)
        Colonization3 (10)14 (19)
        Othera02 (3)
    Age group (yr)0.2
        <19 (30)26 (35)
        1–27 (23)8 (11)
        3–52 (7)13 (17)
        6–129 (30)15 (20)
        13–183 (10)13 (17)
    Gender0.3
        Male14 (47)43 (57)
        Female16 (53)32 (43)
    Race0.1
        African-American23 (77)42 (56)
        White3 (10)15 (20)
        Unknown or other4 (13)18 (24)
    Type of insurance0.5
        Public assistance23 (77)49 (65)
        Private6 (20)24 (32)
        Uninsured1 (3)2 (3)
    Presence of risk factors for HA-MRSA
        Inpatient culture obtained >48 h after admission13 (46)31 (41)0.6
        Hospital stay, past yr8 (27)29 (39)0.2
        Surgery, past yr5 (17)26 (35)0.07
        Hemodialysis, past yr00NAc
        Indwelling catheter9 (30)30 (40)0.9
        Stay in long-term-care facility, past yr03 (4)0.6
    Location of careb0.1
        Intensive care units9 (30)32 (43)
        Other inpatient units13 (43)26 (35)
        Emergency department4 (13)6 (8)
        Outpatient2 (7)11 (15)
        Unknown2 (7)0
    CDC criteria for infection type0.2
        CA12 (40)21 (28)
        HO13 (45)31 (41)
        HACO4 (14)23 (31)
    Previous MRSA isolation, UCMC laboratory report5 (17)2 (3)0.02
    • ↵a Other clinical syndromes include sinusitis and liver abscess.

    • ↵b The location of care was unknown for 2 subjects.

    • ↵c NA, not applicable.

Additional Files

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      Table S1 (Genotyping results for studies of MRSA isolates in the United States, 1988 to 2000)

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Pediatric Staphylococcus aureus Isolate Genotypes and Infections from the Dawn of the Community-Associated Methicillin-Resistant S. aureus Epidemic Era in Chicago, 1994 to 1997
Michael Z. David, Mary Ellen Acree, Julia J. Sieth, Dave J. Boxrud, Ginette Dobbins, Ruth Lynfield, Susan Boyle-Vavra, Robert S. Daum
Journal of Clinical Microbiology Jul 2015, 53 (8) 2486-2491; DOI: 10.1128/JCM.00096-15

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Pediatric Staphylococcus aureus Isolate Genotypes and Infections from the Dawn of the Community-Associated Methicillin-Resistant S. aureus Epidemic Era in Chicago, 1994 to 1997
Michael Z. David, Mary Ellen Acree, Julia J. Sieth, Dave J. Boxrud, Ginette Dobbins, Ruth Lynfield, Susan Boyle-Vavra, Robert S. Daum
Journal of Clinical Microbiology Jul 2015, 53 (8) 2486-2491; DOI: 10.1128/JCM.00096-15
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