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    • "This strain is known to be abundant in the United States and it has also been detected in Canada, Australia, and, to a lesser extent, in Western Europe. It possibly emerged in the Caribbean [32] where PVL-positive CC8-MSSA are common [33], [34]. CC8-MRSA-IV (“USA300”) was already found in neighbouring Bulgaria [20] and there was also previous evidence for its presence in Romania [http://registration.akm.ch/ "
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    ABSTRACT: Romania is one of the countries with the highest prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in the world. To obtain data on affiliation of MRSA to strains and clonal complexes and on the population of methicillin susceptible S. aureus (MSSA), clinical isolates from bloodstream infections, skin and soft tissue infections as well as from screening swabs were collected at hospitals in Ia?i, a city in the North-Eastern part of Romania. Isolates were characterised by microarray hybridisation. Nearly half of all isolates (47%), and about one third (34%) of bloodstream isolates were MRSA. The prevalence of the Panton-Valentine leukocidin (PVL) was also high (31% among MRSA, 14% among MSSA). The most common MRSA strain was a PVL-negative CC1-MRSA-IV that might have emerged locally, as a related MSSA was also common. PVL-positive CC8-MRSA-IV ("USA300") and PVL-negative ST239-like MRSA-III were also frequently found while other MRSA strains were only sporadically detected. Among MSSA, PVL-positive CC121 as well as PVL-negative CC1, CC22 and CC45 predominated. Although this study provides only a snapshot of S. aureus/MRSA epidemiology in Romania, it confirms the high burden of MRSA and PVL on Romanian healthcare settings.
    PLoS ONE 05/2014; 9(5):e97833. DOI:10.1371/journal.pone.0097833 · 3.23 Impact Factor
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    • "PVL-positive CC8-MSSA were very common on the islands, as noted previously [8], such that the causative agent from a recently reported fatal case of PVL-associated disease [7] was a rather typical specimen. As previously observed, the high prevalence of this strain in the Caribbean and its rarity in other parts of the world might indicate that the pandemic CC8 CA-MRSA strain “USA300” emerged in this region [8], [25]. However, it is not yet clear whether the abundance of PVL-positive CC8-MSSA in Trinidad and Tobago is paralleled on other West Indian/Caribbean islands and in Latin America or if it indicates a local outbreak situation. "
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    ABSTRACT: It has been shown previously that high rates of methicillin- and mupirocin-resistant Staphylococcus aureus exist in the Caribbean islands of Trinidad and Tobago, as well as a high prevalence of Panton-Valentine leukocidin-positive S. aureus. Beyond these studies, limited typing data have been published. In order to obtain insight into the population structure not only of MRSA but also of methicillin-susceptible S. aureus, 294 clinical isolates collected in 2012/2013 were typed by microarray hybridisation. A total of 15.31% of the tested isolates were MRSA and 50.00% were PVL-positive. The most common MSSA strains were PVL-positive CC8-MSSA (20.41% of all isolates tested), PVL-positive CC152-MSSA (9.52%) and PVL-positive CC30-MSSA (8.84%) while the most common MRSA were ST239-MRSA-III&SCCmer (9.18%) and ST8-MRSA-IV, "USA300" (5.78%). 2.38% of characterised isolates belonged to distinct strains likely to be related to "Staphylococcus argenteus" lineages. The population structure of S. aureus isolates suggests an importation of strains from Africa, endemicity of PVL-positive MSSA (mainly CC8) and of ST239-MRSA-III, and a recent emergence of the PVL-positive CC8-MRSA-IV strain "USA300".
    PLoS ONE 02/2014; 9(2):e89120. DOI:10.1371/journal.pone.0089120 · 3.23 Impact Factor
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    • "While PVL genes are uncommon in CC8-MSSA, there is a common and widespread MRSA strain from the same lineage, which is known as USA300. Interestingly, this strain has also been described in Colombia [11], geographically close to Trinidad and Tobago. Thus it is tempting to speculate on a possible phylogenetic relationship between USA300 and the strain described in this study. "
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    ABSTRACT: Certain Staphylococcus aureus strains produce Panton-Valentine leukocidin, a toxin that lyses white blood cells causing extensive tissue necrosis and chronic, recurrent or severe infection. This report documents a confirmed case of methicillin-sensitive Staphylococcus aureus strain harboring Panton-Valentine leukocidin genes from Trinidad and Tobago. To the best of our knowledge, this is the first time that such a case has been identified and reported from this country. A 13-year-old Trinidadian boy of African descent presented with upper respiratory symptoms and gastroenteritis-like syptoms. About two weeks later he was re-admitted to our hospital complaining of pain and weakness affecting his left leg, where he had received an intramuscular injection of an anti-emetic drug. He deteriorated and developed septic arthritis, necrotizing fasciitis and septic shock with acute respiratory distress syndrome, leading to death within 48 hours of admission despite intensive care treatment. The infection was caused by S. aureus. Bacterial isolates from specimens recovered from our patient before and after his death were analyzed using microarray DNA analysis and spa typing, and the results revealed that the S. aureus isolates belonged to clonal complex 8, were methicillin-susceptible and positive for Panton-Valentine leukocidin. An autopsy revealed multi-organ failure and histological tissue stains of several organs were also performed and showed involvement of his lungs, liver, kidneys and thymus, which showed Hassal's corpuscles. Rapid identification of Panton-Valentine leukocidin in methicillin-sensitive S. aureus isolates causing severe infections is necessary so as not to miss their potentially devastating consequences. Early feedback from the clinical laboratories is crucial.
    Journal of Medical Case Reports 04/2011; 5(1):157. DOI:10.1186/1752-1947-5-157
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