Clonal change of methicillin-resistant Staphylococcus aureus isolated from patients with impetigo in Kagawa, Japan

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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Nao Sasai1, Hidemasa Nakaminami1, Manami Iwasaki1

  • 1Department of Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.

The Journal of Dermatology
|February 26, 2019
PubMed

Insights

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains in Japan shifted significantly over a decade. A typical impetigo strain declined, while a more pathogenic CA-MRSA/J clone increased, altering antibiotic resistance patterns.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains, including the USA300 clone, have emerged globally.
  • Long-term surveillance data on CA-MRSA clonal types in Japan are limited.
  • Understanding CA-MRSA strain transitions is crucial for public health interventions.

Purpose of the Study:

  • To investigate the clonal type transitions and antibiotic susceptibility of CA-MRSA strains causing impetigo in Japan over a 10-year period (2007-2016).
  • To identify shifts in the prevalence of specific CA-MRSA clones and their association with antibiotic resistance.

Main Methods:

  • Molecular epidemiological analysis of CA-MRSA strains isolated from impetigo outpatients.
  • Tracking the prevalence of specific clonal complexes (e.g., CC89-II, CC8-IV) and Panton-Valentine leukocidin (PVL) positivity.
  • Analysis of antibiotic susceptibility patterns for gentamicin and clindamycin.

Main Results:

  • The overall MRSA detection rate slightly decreased from 22.8% over 10 years.
  • Prevalence of the typical impetigo clone CC89-II significantly decreased from 48.0% to 21.9%.
  • A highly pathogenic CA-MRSA/J clone (non-USA300 CC8-IV) significantly increased from 9.0% to 32.9%.
  • PVL-positive CA-MRSA strains showed an increasing trend, though USA300 remained rare.
  • Resistance rates to gentamicin and clindamycin decreased, correlating with clonal shifts.

Conclusions:

  • CA-MRSA clonal types causing impetigo in Japan have dramatically shifted over the past decade.
  • These shifts are associated with changes in antibiotic resistance profiles.
  • The emergence of the CA-MRSA/J clone may influence future treatment strategies and public health concerns.
Keywords:
CA-MRSA/J cloneclonal complex 8clonal complex 89community-acquired methicillin-resistant Staphylococcus aureusimpetigo

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