Panton-Valentine Leukocidin 양성 지역사회관련 메티실린 내성 황색포도알균에 의한 항문주위 농양 1예: 국내 보고 및 동아시아 증례 문헌고찰
A Case of Perianal Abscess due toPanton-Valentine Leukocidin PositiveCommunity-Associated Methicillin-ResistantStaphylococcus aureus : Report in Koreaand Literature Review from the Far East
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최근 Panton-Valentine leukocidin (PVL) 유전자 양성인 지역사회관련 메티실린내성 포도알균이 전세계적으로 보고되고 있지만 국내에서는 아직 드물다. 저자들은 76세 여자환자에서 PVL양성 지역사회관련 메티실린 내성 포도알균에 의한 광범위한 항문주위 농양을 진단하고 성공적으로 치료하였다. 분자역학연구를 통해 본 균주는 미국에서 유행하는 USA300주와 매우 유사하고, staphylococcal cassette chromosome mec mec (SCCmec) type IV, multilocus sequence typing ST8, spa type type 1, accessory gene regulator locus (agr) group I이 관련되어있었다. 문헌조사 결과 동아시아에서 보고된 PVL 양성 지역사회관련 메티실린 내성 포도알균은 분자역학적 특성이 다양하고, 미국 및 유럽 증례와 비교해 PVL 유전자가 비교적 드물었다.
Abstract
Community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) with Panton- Valentine leukocidin (PVL) genes have recently emerged worldwide, but infections due to PVL carrying CA-MRSA strains have never been reported in Korea. We report a case of extensive perianal abscess due to PVL+ CA-MRSA in a 76-year-old Korean female patient, of which genetic background was very close to USA300. It belonged to staphylococcal cassette chromosome mec element (SCCmec) type IV, ST8 of multilocus sequence typing (MLST), type 1 spa type, and accessory gene regulator locus (agr) group I. Comprehensive literature reviews from the Far East showed molecular characteristics were diverse and PVL genes were infrequently found than in western countries.
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