TY - JOUR
T1 - Prevalence and characterisation of Staphylococcus aureus causing community-acquired skin and soft tissue infections on Java and Bali, Indonesia
AU - Santosaningsih, Dewi
AU - Santoso, Sanarto
AU - Setijowati, Nanik
AU - Rasyid, Harun A.
AU - Budayanti, Nyoman S.
AU - Suata, Ketut
AU - Widhyatmoko, Dicky B.
AU - Purwono, Priyo B.
AU - Kuntaman, Kuntaman
AU - Damayanti, Damayanti
AU - Prakoeswa, Cita R.S.
AU - Laurens, Mitchell
AU - van Nierop, Josephine W.I.
AU - Nanninga, Geraldine L.
AU - Oudenes, Neline
AU - de Regt, Michelle
AU - Snijders, Susan V.
AU - Verbrugh, Henri A.
AU - Severin, Juliëtte A.
N1 - Publisher Copyright:
© 2017 John Wiley & Sons Ltd
PY - 2018/1
Y1 - 2018/1
N2 - 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 (SCCmec) 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-SCCmec type IV isolate and a cluster of ST239-MRSA-SCCmec 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.
AB - 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 (SCCmec) 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-SCCmec type IV isolate and a cluster of ST239-MRSA-SCCmec 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.
KW - Indonesia
KW - Panton–Valentine leukocidin
KW - Staphylococcus aureus
KW - exfoliative toxin
KW - methicillin-resistant Staphylococcus aureus
KW - skin and soft tissue infections
UR - http://www.scopus.com/inward/record.url?scp=85037369530&partnerID=8YFLogxK
U2 - 10.1111/tmi.13000
DO - 10.1111/tmi.13000
M3 - Article
C2 - 29124834
AN - SCOPUS:85037369530
SN - 1360-2276
VL - 23
SP - 34
EP - 44
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 1
ER -