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International Journal of Pediatrics
Volume 2011 (2011), Article ID 143872, 8 pages
Clinical Study

Predominant Dissemination of PVL-Negative CC89 MRSA with SCCmec Type II in Children with Impetigo in Japan

1Pediatric Clinic, Touei Hospital, N-41, E-16, Higashi-ku, Sapporo 007-0841, Japan
2Department of Pediatrics, Health Sciences University of Hokkaido, Kita-ku, Sapporo 002-8072, Japan
3Nakata Pediatric Clinic, Shiroishi-ku, Sapporo 003-0023, Japan
4Yamanaka Tatsuru Pediatrics, Shiroishi-ku, Sapporo 003-0022, Japan
5Department of Pediatrics, Asahikawa Kosei Hospital, Asahikawa 078-8211, Japan
6Department of Laboratory Medicine, Hokkaido University Medical Hospital, Kita-ku, Sapporo 060-0814, Japan
7Department of Pediatrics, Sapporo Hokuyu Hospital, Shiroishi-ku, Sapporo 003-0006, Japan

Received 10 September 2011; Revised 10 October 2011; Accepted 17 October 2011

Academic Editor: Hans Juergen Laws

Copyright © 2011 H. Kikuta et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The ratio of CA-MRSA in children with impetigo has been increasing in Japan. Methods. Antimicrobial susceptibilities of 136 S. aureus isolates from children with impetigo were studied. Furthermore, molecular epidemiological analysis and virulence gene analysis were performed. Results. Of the 136 S. aureus isolates, 122 (89.7%) were MSSA and 14 (10.3%) were MRSA. Of the 14 MRSA strains, 11 belonged to CC89 (ST89, ST91, and ST2117) and carried diverse types of SCCmec: type II (IIb: 3 strains; unknown subtype: 4 strains), type IVa (2 strains), and unknown type (2 strains). The remaining three strains exhibited CC8 (ST-8)-SCCmec type VIa, CC121 (ST121)-SCCmec type V, and CC5 (ST5)-nontypeable SCCmec element, respectively. None were lukS-PV-lukF-PV gene positive. Gentamicin- and clarithromycin-resistant strains were frequently found in both MRSA and MSSA. Conclusions. PVL-negative CC89-SCCmec type II strains are the most predominant strains among the CA-MRSA strains circulating in the community in Japan.