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KMID : 1143420200130473340
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Public Health Weekly Report
2020 Volume.13 No. 47 p.3340 ~ p.3347
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Characteristics of vancomycin-intermediate Staphylococcus aureus (VISA) isolates in Korea, 2016-2018
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Joo Seong-Jae
Go Eun-Byeul
Hwang Kyu-Jam
Yoo Jae-Il
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Abstract
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Vancomycin an antibiotic used to threat a number of bacterial infections, is used for treatment of methicillin-resistant Staphylococcus aureus (MRSA). Since the first isolate of vancomycin-intermediate staphylococcus aureus (VISA) from Japan in 1996, and the discovery of the isolate of the vancomycin-resistant Staphylococcus aureus (VRSA) in the United States in 2002, a major concern for many countries with vancomycin-intermediate and vancomycin-resistant staphylococcus aureus. This study airmed to identify the characteristics of VISA isolates in Korea from 2016 to 2018.
As a result of study, the antimicrobial susceptibility test of 80 strains of Staphylococcus aureus obtained through sentinel surveillance and a thorough investigation from 2016 to 2018, 9 strains of vancomycin-intermediate resistant (4-8 ㎍/㎖) strains were identified. Vancomycin intermediate S. aureus confirmed the characteristics of the vancomycin intermediate S. aureus, a resistance pattern to 20 antibiotics other than vancomycin. In addition, mobility gene (SCCmec) types and 9 types of Staphylococcal enterotoxin genes and toxic shock syndrome toxin-1 (TSST-1), which causes staphylococcal toxic shock syndrome (TSS) such as fever, blood pressure reduction, redness, etc... and panton-valentine leukocidin (PVL), a toxin that destroys cells by puncturing immune cells and among extracellular toxins three types of exfoliative toxin, which causes Staphylococcal scalded skin syndrome (SSSS) were identified. In addition, pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and staphylococcal preotein A (SPA) Typing were confirmed for molecular epidemiological characteristics.
This study’s results indicated that vancomycin intermediate resistant S. aureus was resistant to all beta-lactam antibiotics and resistant to non-betalactam-series quinolone and tetracycline antibiotics, and all 9 strains were identified as multidrug resistant bacteria. Enterotoxic genes sec, seg and sei were found in 8 strains, and TSST-1 were also detected in 8 strains. However exfoliative, panton-valentine leukocidin genes were not detected. ST5 (SCCmec II-ST5-t2460) with type SCCmec II was identified in 7 strains. As a result of the PFGE analysis of 9 strains of vancomycin intermediate S. aureus, 4 types were identified, and the 3 types showed a similarity category of 93.2%.
In this study, the characteristics of vancomycin intermediate S. aureus showed multidrug resistant in all 9 strains, and was consistent with previous reports of ST5 (SCCmec II-ST5-t2460) with SCCmec type II, which is dominant in Korea. Therefore, in order to prevent the emergence of VRSA in Korea and to promptly take action when it occurs, continuous monitoring and characteristic analysis of VRSA is required.
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KEYWORD
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Vancomycin intermediate Staphylococcus aureus (VISA), PFGE, MLST, SCCmec
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