{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T07:18:51Z","timestamp":1787987931154,"version":"build-2784847793"},"reference-count":41,"publisher":"Microbiology Society","issue":"3","funder":[{"name":"European Society for Paediatric Infectious Disease","award":["ESPID Small Grant 2017"],"award-info":[{"award-number":["ESPID Small Grant 2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,31]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold>\n                  <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">Staphylococcus aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> infections cause significant morbidity and mortality in children and adolescents.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Gap Statement.<\/jats:bold> There is limited data on the characteristics of <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">S. aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> infections requiring hospitalization in childhood.<\/jats:p>\n               <jats:p> \n                  <jats:bold>Aim.<\/jats:bold>To investigate the molecular epidemiology and antibiotic resistance of <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">S. aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> clinical isolates from children and adolescents.<\/jats:p>\n               <jats:p> \n                  <jats:bold>Methodology.<\/jats:bold>All <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">S. aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> isolates recovered from patients aged &lt;18\u2009years, admitted to a referral hospital, with culture-proven invasive or non-invasive infections during the 4\u2009year period 2015 to 2018 were analysed for antimicrobial resistance, virulence genes, PFGE and multilocus sequence typing (MLST). Cases were assigned to community-associated, community-onset healthcare-associated or hospital-associated infections based on epidemiological case definitions.<\/jats:p>\n               <jats:p> \n                  <jats:bold>Results.<\/jats:bold>Among 139\u2009<jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">S. aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> infections, 88.5\u200a% (123\/139) were caused by methicillin-susceptible isolates (MSSA) and 73.4\u200a% (102\/139) were classified as community-associated infections. <jats:italic>tst<\/jats:italic> and <jats:italic>lukS\/lukF-PV<\/jats:italic> genes were more common among MRSA as compared to MSSA isolates (<jats:italic>tst,<\/jats:italic> p 0.04; <jats:italic>lukS\/lukF-PV,<\/jats:italic> p 0.007). Invasive disease was noted in 22\/139\u2009patients (15.8\u200a%). Staphylococcal scalded skin syndrome caused by fusidic-resistant MSSA increased over time (22.8\u200a% in 2017\u20132018 vs 8.3\u200a% in 2015\u20132016, OR 3.24; 95\u200a%\u2009CI 1.10\u20138.36; <jats:italic>P<\/jats:italic> 0.03). By PFGE genotyping, 22 pulsotypes were identified. A total of five sequence types (STs) were identified among 58 isolates analysed by MLST. More than one third of MSSA isolates (40\/123, 32.5\u200a%) and 13\/23 (56.5\u200a%) of SSSS isolates belonged to pulsotype 1, classified as sequence type 121 (ST121). MRSA isolates were equally distributed to pulsotypes A (ST30), B (ST239), C (ST80), H (ST225). ST121 isolates carried <jats:italic>fnbA<\/jats:italic> (40\/40), <jats:italic>eta\/etb<\/jats:italic> genes (29\/40), exhibited high resistance to fusidic acid and were increasingly resistant to mupirocin.<\/jats:p>\n               <jats:p> \n                  <jats:bold>Conclusion.<\/jats:bold>In our population, community-associated MSSA was the predominant cause of <jats:italic>\n                     <jats:named-content content-type=\"species\">\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/doi.org\/10.1601\/nm.11043\" xlink:type=\"simple\">S. aureus<\/jats:ext-link>\n                     <\/jats:named-content>\n                  <\/jats:italic> infections characterized by polyclonality, increasing resistance to fusidic acid and mupirocin. PFGE type 1 ST121 clone, harboured exfoliative toxin genes and was associated with rising trends of SSSS.<\/jats:p>","DOI":"10.1099\/jmm.0.001511","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T17:16:06Z","timestamp":1648746966000},"source":"Crossref","is-referenced-by-count":10,"title":["Predominance of community-associated, methicillin-susceptible Staphylococcus aureus infections among hospitalized children and adolescents"],"prefix":"10.1099","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3216-0143","authenticated-orcid":false,"given":"Maria","family":"Tsirigotaki","sequence":"first","affiliation":[{"name":"Department of Paediatrics, School of Medicine, University of Crete, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Giormezis","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Staphylococci, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0945-1732","authenticated-orcid":false,"given":"Sofia","family":"Maraki","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Heraklion University Hospital, Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-6378","authenticated-orcid":false,"given":"Iris","family":"Spiliopoulou","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Staphylococci, School of Medicine, University of Patras, Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8456-5292","authenticated-orcid":false,"given":"Emmanouil","family":"Galanakis","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, School of Medicine, University of Crete, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00134-14"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001753"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238991"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3802-0"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05352-5"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181ef2477"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/S0928-8244(03)00225-6"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.3390\/toxins2051148"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12541"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.micro.112408.134309"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.02433"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00133-11"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2013.11.004"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1271\/bbb.68.981"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.3201\/eid0908.030089"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2008.02064.x"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2019.08.008"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.3201\/eid1302.060781"},{"key":"R19","volume-title":"Performance standards for antimicrobial susceptibility testing: 28th informational supplement.Wayne, PA: Clinical and Laboratory Standards Institute. 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