424. Staphylococcal Scalded Skin Syndrome is dominantly caused by Methcillin Resistent Staphylococcus aureus among children in Tokyo
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Ayako Kubota.pdf (1.2 MB)
  • Background: Staphylococcus aureus is a significant pathogen for children that produces toxins and causes various infections at communities and hospitals. Little is reported regarding the microbiological characteristics of S aureus that caused infections among children in Japan. The purpose of our study is to investigate the susceptibility and the toxin profile of S aureus with clinical diagnosis among children in Japan.

    Methods: We prospectively registered S aureus isolated from children with diseases that required antimicrobial treatment at outpatient and inpatient at Tokyo Metropolitan Children’s Medical Center between March 2010 and March 2013. The isolates of S aureus were tested for susceptibility, coagulase typing, Staphylococcal Enterotoxins (SEs), Toxic Shock Syndrome Toxin-1 (TSST-1), Exfoliative Toxins (ETs). Panton-Valentine Leukocidin (PVL) were tested for Methicillin Resistant  Staphylococcus aureus(MRSA). Genotyping was performed for the selected isolates. We evaluated the microbiological characteristics related to the clinical diagnosis.

    Results: The total of 133 isolates of S aureus was registered. Skin infections were 42 (42/133, 32%); among those, Staphylococcal Scalded Skin Syndrome (SSSS) was 17 (17/133, 13%). Catheter related blood stream infection, osteomyelitis and septic arthritis were 17 (17/133, 13%), 11 (11/133, 8%) and 7 (7/133, 5%), respectively. Methicillin Susceptible S aureus (MSSA) and MRSA were 68 (68/133, 51%) and 65 (65/133, 49%), respectively. The isolates with SSSS were dominantly MRSA (14/17, 82%), Coagulase Ⅰ (15/17, 88%) and ET B (15/17, 88%). Genotyping was performed in 4 of those MRSA isolates; all of them were Clonal Complex 89 and SCCmec Ⅱb. Other clinical diseases were not related to specific microbiologic characteristics.

    Conclusion: SSSS was dominantly caused by MRSA with CoagulaseⅠand ET B in our study. Although genotyping was performed in limited isolated, this specific strain for SSSS may be endemic among children in Japan. It is reasonable to use an anti-MRSA agent empirically for SSSS, if treatment is indicated.

    Ayako Kubota, MD1, Takayo Shoji, MD1, Shintaro Hirotaki, MD, PhD1, Kaoru Goto2, Tomoyuki Tame2, Hiroshi Higuchi2, Michiko Miyahara3, Saeko Morino, MD1, Mihoko Isogai, MD1, Yoshihiko Morikawa, MD4 and Yuho Horikoshi, MD1, (1)Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan, (2)Microbiology, Tokyo Metropolitan Children' s Medical Center, Tokyo, Japan, (3)Microbiology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan, (4)Clinical Research, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan


    A. Kubota, None

    T. Shoji, None

    S. Hirotaki, None

    K. Goto, None

    T. Tame, None

    H. Higuchi, None

    M. Miyahara, None

    S. Morino, None

    M. Isogai, None

    Y. Morikawa, None

    Y. Horikoshi, None

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