Prevalence and characterisation of Staphylococcus aureus causing community‐acquired skin and soft tissue infections on Java and Bali, Indonesia. Issue 1 (4th December 2017)

• Record Type: Journal Article
• Authors: Santosaningsih, Dewi; Santoso, Sanarto; Setijowati, Nanik; Rasyid, Harun A.; Budayanti, Nyoman S.; Suata, Ketut; Widhyatmoko, Dicky B.; Purwono, Priyo B.; Kuntaman, Kuntaman; Damayanti, Damayanti; Prakoeswa, Cita R. S.; Laurens, Mitchell; van Nierop, Josephine W. I.; Nanninga, Geraldine L.; Oudenes, Neline; de Regt, Michelle; Snijders, Susan V.; Verbrugh, Henri A.; Severin, Juliëtte A.
• Is Part Of: Tropical medicine & international health. Volume 23:Issue 1(2018)
• Page Start: 34
• Page End: 44
• Publication Date: 2017-12-04
• Subjects: exfoliative toxin -- Indonesia -- methicillin‐resistant Staphylococcus aureus -- Panton–Valentine leukocidin -- skin and soft tissue infections -- Staphylococcus aureus; toxine exfoliative -- Indonésie -- SAMR -- leucocidine de Panton‐Valentine -- infections de la peau et des tissus mous -- Staphylococcus aureus; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.13000
• Languages: English
• ISSNs: 1360-2276

Abstract

Abstract: Objectives: To define the role of Staphylococcus aureus in community settings among patients with skin and soft tissue infections (SSTI) in Indonesia. Methods: Staphylococcus aureus were cultured from anterior nares, throat and wounds of 567 ambulatory patients presenting with SSTI. The mecA gene and genes encoding Panton–Valentine leukocidin (PVL; lukF‐PV and lukS‐PV ) and exfoliative toxin (ET; eta and etb ) were determined by PCR. Clonal relatedness among methicillin‐resistant S. aureus (MRSA) and PVL‐positive S. aureus was analysed using multilocus variable‐number tandem‐repeat analysis (MLVA) typing, and multilocus sequence typing (MLST) for a subset of isolates. Staphylococcal cassette chromosome mec (SCC mec ) was determined for all MRSA isolates. Moreover, determinants for S. aureus SSTI, and PVL/ET‐positive vs PVL/ET‐negative S. aureus were assessed. Results: Staphylococcus aureus were isolated from SSTI wounds of 257 (45.3%) patients, eight (3.1%) of these were MRSA. Genes encoding PVL and ETs were detected in 21.8% and 17.5% of methicillin‐susceptible S. aureus (MSSA), respectively. PVL‐positive MRSA was not detected. Nasopharyngeal S. aureus carriage was an independent determinant for S. aureus SSTI (odds ratio [OR] 1.8). Primary skin infection (OR 5.4) and previous antibiotic therapy (OR 3.5) were associated with PVL‐positive MSSA. Primary skin infection (OR 2.2) was the only factor associated with ET‐positive MSSA. MLVA typing revealed two more prevalent MSSA clusters. One ST1‐MRSA‐SCC mec type IV isolate and a cluster of ST239‐MRSA‐SCC mec type III were found. Conclusions: Community‐acquired SSTI in Indonesia was frequently caused by PVL‐positive MSSA, and the hospital‐associated ST239‐MRSA may have spread from the hospital into the community.