J Korean Med Sci.  2013 Jul;28(7):1100-1102. 10.3346/jkms.2013.28.7.1100.

First Imported Case of Skin Infection Caused by PVL-positive ST30 Community-Associated Methicillin-Resistant Staphylococcus aureus Clone in a Returning Korean Traveler from the Philippines

• Ko J
• Chung DR
• Park SY
• Baek JY
• Kim SH
• Kang CI
• Peck KR
• Lee NY
• Song JH

• KMID: 1777510
• DOI: http://doi.org/10.3346/jkms.2013.28.7.1100

Abstract

Although pandemic community-associated (CA-) methicillin-resistant Staphylococcus aureus (MRSA) ST30 clone has successfully spread into many Asian countries, there has been no case in Korea. We report the first imported case of infection caused by this clone in a Korean traveler returning from the Philippines. A previously healthy 30-yr-old Korean woman developed a buttock carbuncle while traveling in the Philippines. After coming back to Korea, oral cephalosporin was given by a primary physician without any improvement. Abscess was drained and MRSA strain isolated from her carbuncle was molecularly characterized and it was confirmed as ST30-MRSA-IV. She was successfully treated with vancomycin and surgery. Frequent international travel and migration have increased the risk of international spread of CA-MRSA clones. The efforts to understand the changing epidemiology of CA-MRSA should be continued, and we should raise suspicion of CA-MRSA infection in travelers with skin infections returning from CA-MRSA-endemic countries.

Keyword

Staphylococcus aureus; Methicillin Resistance; Community-Acquired Infections; Carbuncle; Travel

MeSH Terms

Adult
Bacterial Toxins/metabolism
Carbuncle/microbiology
Cephalosporins/therapeutic use
Community-Acquired Infections/drug therapy/microbiology
Exotoxins/metabolism
Female
Humans
Leukocidins/metabolism
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus/*isolation & purification
Philippines
Republic of Korea
Staphylococcal Skin Infections/*drug therapy/surgery
Travel
Vancomycin/therapeutic use
Bacterial Toxins
Cephalosporins
Exotoxins
Leukocidins
Vancomycin

Figure

• 

  Fig. 1 Pulsed-field gel electrophoresis (PFGE) patterns of MRSA isolates from the patient and control strains. PFGE was performed with restriction enzyme SmaI. Lane 1, USA300 strain (NRS384) obtained from the Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA); lane 2, isolate from the patient (K01-SAU-12-04); lane 3, P01-SAU-05-41 (CA-MRSA collection from the Philippines, ST30-MRSA-IV, t019, PVL-positive); lane 4, P01-SAU-05-66 (CA-MRSA collection from the Philippines, ST30-MRSA-IV, t2670, PVL-positive); lane 5, K01-SAU-04-1325 (ST72-MRSA-IV, t324); M, lambda marker.

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