J Korean Med Sci.  2012 Mar;27(3):313-316. 10.3346/jkms.2012.27.3.313.

Post-influenza Pneumonia Caused by the USA300 Community-Associated Methicillin-Resistant Staphylococcus aureus in Korea

Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. drchung@skku.edu
  • 2Asia Pacific Foundation for Infectious Diseases (APFID), Seoul, Korea.
  • 3Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea.

Abstract

Panton-Valentine leukocidin (PVL)-positive USA300 clone has been the most successful community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clone spreading in North America. In contrast, PVL-negative ST72-CA-MRSA has been predominant in Korea, and there has been no report of infections by the USA300 strain except only one case report of perianal infection. Here, we describe the first case of pneumonia caused by the USA300 strain following pandemic influenza A (H1N1) in Korea. A 50-year-old man was admitted with fever and cough and chest radiograph showed pneumonic consolidation at the right lower lung zone. He received a ventilator support because of respiratory failure. PCR for pandemic influenza A (H1N1) in nasopharyngeal swab was positive, and culture of sputum and endotracheal aspirate grew MRSA. Typing of the isolate revealed that it was PVL-positive, ST 8-MRSA-SCCmec type IV. The analysis of the PFGE patterns showed that this isolate was the same pulsotype as the USA300 strain.

Keyword

Influenza, Human; Methicillin-Resistant Staphylococcus aureus; Pneumonia

MeSH Terms

Community-Acquired Infections/*etiology/microbiology
Humans
Influenza A Virus, H1N1 Subtype
Influenza, Human/*complications
Male
*Methicillin-Resistant Staphylococcus aureus/classification/isolation & purification
Middle Aged
Pneumonia, Staphylococcal/*etiology/microbiology
Republic of Korea
Staphylococcal Infections/*etiology/microbiology

Figure

  • Fig. 1 Chest computerized tomography (CT) scan shows a dense consolidation and necrotizing areas of the right lower lobe.

  • Fig. 2 Pulsed-field gel electrophoresis (PFGE) patterns of MRSA isolate from the patient and control strains obtained from the Network on Antimicrobial Resistance in Staphylococcus aureus (NARSA). PFGE was performed with restriction enzyme SmaI. Lane 1, isolate from the patient; lane 2, NRS384 (USA300); lane 3, NRS123 (USA400); lane 4, NRS385 (USA500); lane 5, NRS386 (USA700); lane 6, NRS387 (USA800); lane 7, NRS483 (USA1000); lane 8, NRS484 (USA1100); M, lambda marker.


Cited by  1 articles

A Case of a Submandibular Abscess caused by Panton-Valentine leukocidin Positive USA 300 Community-associated Methicillin Resistant Staphylococcus aureus in a Foreign Resident of South Korea
Donghyong Jeong, Sangsoo Bae, Inyub Baek, Sangdong Kim, Boyean Kim, Ki Tae Kwon, Kwan Soo Ko, Shinwon Lee
Infect Chemother. 2012;44(6):495-498.    doi: 10.3947/ic.2012.44.6.495.


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