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Background   Staphylococcus aureus , particularly methicillin-resistant  S. aureus  (MRSA), is an important cause of pyogenic skin and soft tissue infections (SSTIs). The aim of present study is to investigate the molecular characteristic of  Staphylococcus aureus  isolates isolated from the pus samples from the patients with purulent skin and soft tissue infections in Wenzhou, China.    Methods  Between December 2002 and June 2008, a total of 111 nonduplicate  S. aureus  isolates were collected from the pus samples of the patients with SSTIs in a teaching hospital in Wenzhou, China. All the tested isolates were confirmed as  S. aureus  using a Staph SPA agglutination kit, Gram's stain and a Vitek-60 microbiology analyzer. The homology among the tested isolates was determined by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) was used to determine the sequence types (STs) of the selected isolates. The genotypes of SCC mec  were determined by a multiplex PCR in the MRSA isolates. Panton-Valentine leukocidin (PVL) genes and  mec A were also determined by another multiplex PCR.    Results  Among the 111  S. aureus  isolates, 48 and 63 isolates were community-acquired and hospital-acquired respectively. Sixty isolates were confirmed as MRSA harboring  mec A detected by PCR. A total of 32 PFGE clonal types were obtained by PFGE, with 10 predominant patterns (types A to J). Twenty-five different STs including ST398 and three novel STs were found among 51 selected isolates. The main STs were ST239, ST1018, ST59, ST7 and ST88. Of 60 MRSA isolates, SCC mec  II, III, IV and SCC mec  V were found in three, 50, three and two isolates, respectively. The positive rates of PVL genes in overall isolates, HA-isolates, CA-isolates, MRSA isolates and MSSA isolates were 23.4% (26/111), 20.6% (13/63), 27.1% (13/48), 21.7% (13/60) and 25.5% (13/51), respectively. Eight (33.3%, 8/24) of 24 CA-MRSA isolates and 5 (13.9%, 5/36) of 36 HA-MRSA isolates were positive for PVL genes. ST239-MRSA-SCC mec III and ST1018-MRSA-SCC mec III clones were found to be main clones and spread between community and hospital.    Conclusion   S. aureus  isolates causing SSTIs showed considerable molecular heterogeneity and harbored high prevalence of PVL genes. Clonal spread was responsible for the dissemination of the isolates of  S. aureus  associated with SSTIs.

Molecular characterization of Staphylococcus aureus isolates causing skin and soft tissue infections (SSTIs)