2180. Dissemination of the Methicillin Resistant Staphylococcus aureus (MRSA) Pediatric Clone (ST5-T002-IV-Pvl+) as a Major Cause of Community Associated (CA) Staphylococcal Infections in Bedouin Children, Southern Israel
Session: Poster Abstract Session: HAI: MRSA, MSSA, and Other Gram Positives
Saturday, October 7, 2017
Room: Poster Hall CD
Posters
  • 2180 CA-MRSA poster ID week 2017.pdf (765.0 kB)
  • Background: Pediatric CA-MRSA infections are emerging worldwide. High CA-MRSA carriage rates were previously described in healthy Bedouin children (Adler et al, J Clin Microbiol 2009). We assessed demographic, clinical and molecular characteristics of MRSA infections in children in southern Israel.

    Methods: Soroka University Medical Center microbiology laboratory serves the entire population of southern Israel, divided into two ethnic groups, Bedouin and Jews. All in-hospital MRSA isolates from children 0-18yr, obtained in 2016 were included.

    Clinical data were recorded from the hospital's computerized records. Health-care associated (HA) and community-associated infections were defined according to the US Center for Disease Control and Prevention.

    All isolates were evaluated for staphylococcal cassette chromosome (SCCmec), Panton-Valentine leucocidin (PVL), Staphylococcus aureus protein A (spa) type as well as by pulsed-field-gel-electrophoresis (PFGE) and antimicrobial susceptibility testing.  

    Results: Overall 95 (18%) of S. aureus isolates were MRSA (Table 1). Twenty-five different MRSA strains were identified. 28 isolates (29.5% of all MRSA) belonged to a pediatric clone, rarely observed in Israel (SCC IV, PVL positive, spa type 002; all demonstrate identical PFGE fingerprints). 82% of infections caused by this clone were community-acquired and were mainly observed in young Bedouin children, causing skin and soft tissue infections (SSTI).  Comparisons between the new clone and other CA-MRSA and HA-MRSA strains are shown in Table 1.

    All isolates of the pediatric clone were susceptible to TMP/SMX, ciprofloxacin, gentamicin, tetracycline, rifampicin and vancomycin; 17.8% were nonsusceptible to erythromycin and clindamycin (Table 2).

    Conclusion: The pediatric CA-MRSA clone, previously described only in sporadic cases in Israel, is emerging among previously healthy, young Bedouin children, typically causing SSTI.  Isolates are susceptible to a variety of non-beta lactam antibiotics.

    Assaf Rokney, PhD1, Moti Baum, PhD1, Shalom Ben-Shimol, MD2,3, Orli Sagi, PhD4, Einav Anuka, BSc1, Vered Agmon, PhD1, David Greenberg, MD2,3, Lea Valinsky, PhD1 and Dana Danino, MD2,3, (1)Government Central Laboratory, Ministry of Health, Beer-Sheva, Israel, (2)Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel, (3)Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel, (4)Microbiology Laboratory, Soroka University Medical Center, Beer-Sheva, Israel

    Disclosures:

    A. Rokney, None

    M. Baum, None

    S. Ben-Shimol, None

    O. Sagi, None

    E. Anuka, None

    V. Agmon, None

    D. Greenberg, None

    L. Valinsky, None

    D. Danino, None

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