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The emerging ST8 methicillin-resistant Staphylococcus aureus clone in the community in Japan: associated infections, genetic diversity, and comparative genomics

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Journal of Infection and Chemotherapy

Abstract

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a major concern worldwide. In the United States, ST8 CA-MRSA with SCCmecIVa (USA300) has been predominant, affecting the entire United States. In this study, we investigated Japanese ST8 CA-MRSA with new SCCmecIVl (designated ST8 CA-MRSA/J), which has emerged in Japan since 2003. Regarding community spread and infections, ST8 CA-MRSA/J spread in 16.2–34.4% as a major genotype in the community in Japan, and was associated with skin and soft tissue infections (SSTIs), colitis, and invasive infections (sepsis, epidural abscesses, and necrotizing pneumonia), including influenza prodrome cases and athlete infections, similar to USA300. It spread to even public transport and Hong Kong through a Japanese family. Regarding genetic diversity, ST8 CA-MRSA/J included ST and spa variants and was classified into at least three pulsed-field gel electrophoresis types, ST8 Jα to γ. Of those, ST8 Jβ was associated with severe invasive infections. As for genomics, ST8 CA-MRSA/J showed high similarities to USA300, but with marked diversity in accessory genes; e.g., ST8 CA-MRSA/J possessed enhanced cytolytic peptide genes of CA-MRSA, but lacked the Panton–Valentine leukocidin phage and arginine catabolic mobile element, unlike USA300. The unique features of ST8 CA-MRSA/J included a novel mosaic SaPI (designated SaPIj50) carrying the toxic shock syndrome toxin-1 gene with high expression; the evolution included salvage (through recombination) of hospital-acquired MRSA virulence. The data suggest that ST8 CA-MRSA/J has become a successful native clone in Japan, in association with not only SSTIs but also severe invasive infections (posing a threat), requiring attention.

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Acknowledgments

We thank Jerome Etienne, L.K. McDougal, and L.L. McDonald for MRSA reference strains and Kohei Akazawa for statistical analysis.

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Authors and Affiliations

  1. Division of Bacteriology, Department of Infectious Disease Control and International Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

    Yasuhisa Iwao, Tomomi Takano, Wei-Chun Hung, Wataru Higuchi, Hirokazu Isobe, Akihito Nishiyama, Olga Khokhlova & Tatsuo Yamamoto

  2. Department of Pediatrics, Akashi Municipal Hospital, Akashi, Hyogo, Japan

    Rumiko Ishii & Mio Yano

  3. Kyoto Prefectural University of Medicine, Kyoto, Japan

    Rumiko Ishii & Mio Yano

  4. Department of Respiratory Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

    Yusuke Tomita

  5. Department of Respiratory Medicine, Tokyo Metropolitan Bokuto General Hospital, Tokyo, Japan

    Yasuhiro Shibuya

  6. Department of Microbiology, Tokyo Medical University, Tokyo, Japan

    Tetsuya Matsumoto

  7. Oita Prefectural Institute of Public Health and Environmental Science, Oita, Japan

    Kikuyo Ogata

  8. Niigata Prefectural Muikamachi Hospital, Niigata, Japan

    Takeshi Okubo

  9. Department of Microbiology, Centre of Infection, University of Hong Kong, Hong Kong, China

    Pak-Leung Ho

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  1. Yasuhisa Iwao
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  16. Tatsuo Yamamoto
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Correspondence to Tatsuo Yamamoto.

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Iwao, Y., Ishii, R., Tomita, Y. et al. The emerging ST8 methicillin-resistant Staphylococcus aureus clone in the community in Japan: associated infections, genetic diversity, and comparative genomics. J Infect Chemother 18, 228–240 (2012). https://doi.org/10.1007/s10156-012-0379-6

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  • DOI: https://doi.org/10.1007/s10156-012-0379-6

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