Molecular analysis of repeated methicillin-resistant Staphylococcus aureus infections in children

Chih Jung Chen, Lin Hui Su, Tzou Yien Lin, Yhu Chering Huang

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen that causes severe morbidity and mortality in hospitalized patients. It is unclear whether repeated MRSA infections in pediatric patients are caused by relapse of previous infecting strains or by acquiring new strains from extrinsic sources. The study aimed to define the genetic relatedness of MRSA isolates from children with repeated infections. Methodology/Principal Findings: Children with multiple MRSA infections during 2004-2006 were identified in a teaching hospital. Repeated infections were confirmed by chart review and the responsible isolates were genotyped and screened for Panton-Valentine leukocidin (PVL) genes. Two consecutive episodes comprised an infection pair, and strain relatedness was defined for each pair as indistinguishable, highly related, or distinct if the isolates were of the same subtype, the same genotype, or different genotype, respectively. A total of 114 episodes comprising 66 infection pairs were identified in 48 children. The interval of infection pairs ranged from 15 days to 346 days, with a median duration of 57.5 days. Genotypings classified all isolates into 7 genotypes and 31 subtypes. Of 66 pairs, 46 (69.7%), 13 (19.7%) and 7 (10.6%) pairs were caused by indistinguishable, highly related and distinct strains, respectively. Subsequent infections caused by indistinguishable strains were more common for PVL-positive strains (17/18, 94.4%) than for PVL-negative strains (29/48, 60.4%, P = 0.007). The strain relatedness was not affected by the durations of interval between infections. Conclusions/Significance: Most repeated MRSA infections in children are caused by indistinguishable strains even after a long period of interval, suggesting that persistent carriage and relapse of initial infecting strains were responsible for the majority of recurrent MRSA infections.

Original languageEnglish
Article numbere14431
JournalPLoS One
Volume5
Issue number12
DOIs
Publication statusPublished - 2010
Externally publishedYes

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Methicillin
Methicillin-Resistant Staphylococcus aureus
Infection
infection
Genotype
relapse
genotype
methicillin-resistant Staphylococcus aureus
Pediatrics
Recurrence
duration
Pathogens
Teaching Hospitals
genotyping
genetic relationships
Teaching
morbidity
Genes
Morbidity

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Molecular analysis of repeated methicillin-resistant Staphylococcus aureus infections in children. / Chen, Chih Jung; Su, Lin Hui; Lin, Tzou Yien; Huang, Yhu Chering.

In: PLoS One, Vol. 5, No. 12, e14431, 2010.

Research output: Contribution to journalArticle

Chen, Chih Jung ; Su, Lin Hui ; Lin, Tzou Yien ; Huang, Yhu Chering. / Molecular analysis of repeated methicillin-resistant Staphylococcus aureus infections in children. In: PLoS One. 2010 ; Vol. 5, No. 12.
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