Journal Article

Molecular Characterization of Invasive <i>Staphylococcus aureus</i> Infection in Central New York Children: Importance of Two Clonal Groups and Inconsistent Presence of Selected Virulence Determinants

Manika Suryadevara, Andrew E. Clark, Donna M. Wolk, Aubri Carman, Paula F. Rosenbaum and Jana Shaw

in Journal of the Pediatric Infectious Diseases Society

Published on behalf of Pediatric Infectious Diseases Society

Volume 2, issue 1, pages 30-39
Published in print March 2013 | ISSN: 2048-7193
Published online September 2012 | e-ISSN: 2048-7207 | DOI: http://dx.doi.org/10.1093/jpids/pis087
Molecular Characterization of Invasive Staphylococcus aureus Infection in Central New York Children: Importance of Two Clonal Groups and Inconsistent Presence of Selected Virulence Determinants

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Background

The genetic makeup of circulating Staphylococcus aureus (SA) populations varies by region. The extent to which SA virulence determinants contribute to the severity of pediatric infections is poorly understood. The study objective was to describe the genetic population of invasive SA (ISA) isolates from children in the Central New York (CNY) area and the prevalence of selected virulence genes.

Methods

Clinical and demographic information for hospitalized children <19 years of age with community-onset or community-associated ISA infections, determined from clinical microbiology records, was extracted from medical records from Upstate Golisano Children's Hospital in CNY. Antibiotic susceptibility was assessed, and available isolates were genotyped and tested for the presence of selected virulence determinants. Associations between clinical and laboratory findings were evaluated using standard statistical techniques.

Results

Ninety patients with ISA disease diagnosed between 2007 and 2010 were included in the study; 74% were due to methicillin-susceptible SA (MSSA). The most common clinical diagnosis was bacteremia. Fifty-seven of 90 isolates were available for further testing. The SA pulsed-field gel electrophoresis type, agr type, and clonal complexes most commonly isolated were USA300 (n = 25, 44%), agr1 (n = 30, 52%), and CC8 (n = 25, 44%), respectively. USA300 strains were more likely to be associated with deep abscesses (P = .007), whereas non-USA300 strains were associated with medical device infections (P = .018). Isolates from patients with deep abscesses and pneumonia were more likely to carry luk-PV genes (P = .023 and P = .051, respectively).

Conclusions

MSSA remains an important problem of pediatric ISA infection in our region and results from genetically diverse SA populations.

Keywords: Invasive; S aureus; Virulence Determinants; MRSA; MSSA; Children; USA300

Journal Article.  4675 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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