Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureus infections in Chinese children

BMC Infectious Diseases

Xuzhuang Shen¹  Yonghong Yang¹  Sangjie Yu¹  Kaihu Yao¹  Yanhong Dong¹  Ting Zeng¹  Lijuan Wang¹  Juan Li¹  Shipeng Li¹  Fang Dong¹  Yuejie Zheng²  Wenqi Song¹  Ruizhen Zhao²  Qiang Chen⁴  Xue Ning¹  Yanhong Qiao³ 

[1]Key Laboratory of Major Diseases in Children and National Key Discipline of Pediatrics, Ministry of Education, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Beijing, PR China

[2]Shenzhen Children’s Hospital, Shenzhen, PR China

[3]Pediatric Department of Aviation General Hospital, Beijing, PR China

[4]Jiangxi Children’s Hospital, Jiangxi, PR China

关键词: Molecular epidemiology;    Child;    Invasive infection;    Community-acquired;    Staphylococcus aureus;   

Others  :  1122113
DOI  :  10.1186/s12879-014-0582-4

 received in 2014-06-06, accepted in 2014-10-23,  发布年份 2014

【 摘 要 】

Background

This study aims to investigate the clinical features of invasive community-acquired Staphylococcus aureus (CA-SA) infection in Chinese children and analyze its molecular features.

Methods

Clinical data and invasive CA-SA isolates were prospectively collected. Pediatric risk of mortality (PRISM) score was used for disease severity measurement. Molecular typing was then performed, followed by expression analysis for virulence genes.

Results

Among 163 invasive CA-SA infection cases, 71 (43.6%) were methicillin-resistant SA (MRSA) infections and 92 (56.4%) were methicillin-susceptible SA (MSSA). A total of 105 (64.4%) children were younger than 1 year old, and 79.7% (129/163) were under 3 years age. Thirteen kinds of diseases were observed, in which bacteremia and pneumonia accounted for 65.6% (107/163) and 52.8% (86/163), respectively. A total of 112 (68.1%) patients had two or more infective sites simultaneously, and four cases (2.5%) died. CA-MSSA more frequently caused multi-sites infections, bacteremia, and musculoskeletal infection than MRSA. A total of 25 sequence types (STs) were detected. MRSA mainly comprised ST59 (49/71, 69%), whereas the most frequent clonotypes were ST88 (15/92, 16.3%), ST25 (13/92, 14.1%), ST7 (13/92, 14.1%), ST2155 (12/92, 13%), and ST188 (9/92, 9.8%) for MSSA. Seven STs were common to both MSSA and MRSA groups. No differences in clinical presentation or PRISM score were found between the two groups or among different ST. The expression levels of the four known virulence genes varied among the six main ST clones.

Conclusions

Invasive CA-SA infections were characterized by high incidence and multi-site infections in young children in China. The clinical manifestations of CA-MSSA were more frequently associated with multi-site infections, bacteremia and musculoskeletal infection than those of CA-MRSA. Isolated genotypes may be relevant to the expressions of virulence genes, but not to clinical manifestations.

【 授权许可】

   
2014 Qiao et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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