Panton-Valentine leukocidin–positive Staphylococcus aureus in skin and soft tissue infections from primary care patients

Friesen, Johannes; Neuber, Robert; Fuhrmann, Jörg; Kietzmann, H.; Wenzel, Thilo; Schaumburg, Frieder; Müller, Mareike; Ignatius, Ralf

doi:10.1016/j.cmi.2020.06.029

Cited by 11 publications

(5 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results may reflect the fact that 466 of the 980 (47.6%) S. aureus isolates analyzed in this study were obtained from patients with impetigo, which most commonly occurs in children aged 2–5 years ( 46 ). PVL-positive isolates can cause deep-seated SSTIs, such as furuncle and cellulitis, mostly in young and middle-aged adults ( 3 , 47 ); our results are consistent with these reports. The isolation rate of S. aureu s in patients with deep-seated SSTIs remained at 49.5% (Table S2), which may be attributed to the difficulty in collecting causative pathogens of these infections or the presence of pathogens other than S. aureus causing these infections.…”

Section: Discussionsupporting

confidence: 92%

Significant increase in the prevalence of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus , particularly the USA300 variant ΨUSA300, in the Japanese community

Kaneko,

Kanai,

Saito

et al. 2023

Microbiol Spectr

View full text Add to dashboard Cite

USA300, a major Panton–Valentine leukocidin (PVL)-producing methicillin-resistant Staphylococcus aureus (MRSA) clone associated with skin and soft tissue infections (SSTIs), carries a type IV staphylococcal cassette chromosome mec (SCC mec ) element. Recently, a USA300 variant, ΨUSA300, with a 12-bp deletion of ccrB2 in the SCC mec element, was identified in Japan by Takadama et al. (15). To understand the current status of PVL-positive MRSA in the community, a nationwide surveillance of MRSA isolated from outpatients at dermatology departments was conducted. This study included 1,619 outpatients who visited dermatology departments at 22 healthcare facilities in 11 prefectures in Japan between 2018 and 2021; S. aureus were isolated from these outpatients. Molecular epidemiological analysis was performed using PCR, SCC mec and spa typing, pulsed-field gel electrophoresis, multilocus sequence typing, and antimicrobial susceptibility testing. A total of 980 S . aureus were isolated, 293 of which were identified as MRSA. Among MRSA isolates, PVL genes were detected in 18 of 63 (28.6%) in 2018, 34 of 85 (40.0%) in 2019, 29 of 65 (44.6%) in 2020, and 40 in 80 (50.0%) in 2021. Among the PVL-positive MRSA, 16 of 121 (13.2%) and 94 of 121 (77.7%) isolates were identified as USA300 and ΨUSA300, respectively. ΨUSA300 strains were collected from six prefectures in Japan: Kagawa, Osaka, Tokyo, Kanagawa, Fukushima, and Saitama. ΨUSA300 was isolated more frequently than USA300 from patients with deep-seated SSTIs ( P < 0.05). Our findings showed that PVL-positive MRSA isolates were significantly increased in the Japanese community. Furthermore, the USA300 variant ΨUSA300 has emerged as the predominant PVL-positive MRSA clone across the Kanto, Kinki, and Shikoku regions of Japan, and this variant may possess a greater propensity to cause deep-seated SSTIs than in USA300. IMPORTANCE USA300 is an MRSA clone producing PVL, a toxin associated with SSTIs. ΨUSA300 is a USA300 variant recently identified in Japan by Takadama et al. (15). Here, we found that the prevalence rate of PVL-positive MRSA in S. aureus was elevated in the Japanese community, and ΨUSA300 accounted for most of them. ΨUSA300 strains have been isolated from several areas in Japan and were associated with deep-seated SSTIs. This study highlighted the emerging threat posed by ΨUSA300 in Japan.

show abstract

Section: Discussionsupporting

confidence: 92%

Significant increase in the prevalence of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus , particularly the USA300 variant ΨUSA300, in the Japanese community

Kaneko,

Kanai,

Saito

et al. 2023

Microbiol Spectr

View full text Add to dashboard Cite

show abstract

“…PVL-positive MRSA-induced SSTIs are typically considered a therapeutic challenge with more severe/chronic clinical presentations, which impair the quality of life and mental health of patients. Our findings present an intriguing departure from this conventional understanding [ 30–32 ]. Contrary to expectations, we observed that patients with SSTIs caused by PVL-negative MRSA were older, had a higher prevalence of comorbidities, and had longer hospital stays than those with PVL-positive MRSA strains.…”

Section: Discussioncontrasting

confidence: 58%

Epidemiology and clinical features of Skin and Soft Tissue Infections Caused by PVL-Positive and PVL-Negative Methicillin-Resistant Staphylococcus aureus Isolates in inpatients in China: a single-center retrospective 7-year study

Jin,

Zhou,

et al. 2024

Emerging Microbes & Infections

View full text Add to dashboard Cite

Previous studies have mainly focused on outpatient cases of skin and soft tissue infections (SSTIs), with limited attention to inpatient occurrences. Thus, we aimed to compare the clinical parameters of inpatients with SSTIs, performed genomic characterization, and determined the subtypes of Panton-Valentine leucocidin (PVL) bacteriophages of methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from these patients. We found that PVL-positive patients had shorter hospital stays (mean, 9 vs. 24 days; p < 0.001) and abscess resolution durations (mean, 8 vs. 13 days; p < 0.01). PVL-positive MRSA-induced SSTIs were more frequently associated with abscesses [36/55 (65.5%) vs. 15/124 (12.1%), p < 0.001], with 52.7% undergoing incision and drainage; over 80% of PVL-negative patients received incision, drainage, and antibiotics. In PVL-positive patients receiving empirical antibiotics, anti-staphylococcal agents such as vancomycin and linezolid were administered less frequently (32.7%, 18/55) than in PVL-negative patients (74.2%, 92/124), indicating that patients with PVL-positive SSTIs are more likely to require surgical drainage rather than antimicrobial treatment. We also found that the ST59 lineage was predominant, regardless of PVL status (41.3%, 74/179). Additionally, we investigated the linear structure of the lukSF-PV gene, revealing that major clusters were associated with specific STs, suggesting independent acquisition of PVL by different strain types and indicating that significant diversity was observed even within PVL-positive strains detected in the same facility. Overall, our study provides comprehensive insights into the clinical, genetic, and phage-related aspects of MRSA-induced SSTIs in hospitalized patients and contributes to a more profound understanding of the epidemiology and evolution of these pathogens in the Chinese population.

show abstract

“…Panton–Valentine leukocidin is a pore-forming protein consisting of two sub-units (lukF-PV, lukS-PV) that target human granulocytes, monocytes, and macrophages ( Holzinger et al, 2012 ). It is mainly associated with skin and soft tissue infection (SSTI) ( Friesen et al, 2020 ), and in particular, pyomyositis in developing countries ( Shittu et al, 2020a ). This study identified PVL-positive MRSA from nine CCs in 10 countries.…”

Section: Discussionmentioning

confidence: 99%

A 6-Year Update on the Diversity of Methicillin-Resistant Staphylococcus aureus Clones in Africa: A Systematic Review

et al. 2022

View full text Add to dashboard Cite

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of hospital-associated (HA) and community-associated (CA) infections globally. The multi-drug resistant nature of this pathogen and its capacity to cause outbreaks in hospital and community settings highlight the need for effective interventions, including its surveillance for prevention and control. This study provides an update on the clonal distribution of MRSA in Africa.MethodsA systematic review was conducted by screening for eligible English, French, and Arabic articles from November 2014 to December 2020, using six electronic databases (PubMed, EBSCOhost, Web of Science, Scopus, African Journals Online, and Google Scholar). Data were retrieved and analyzed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines (registered at PROSPERO: CRD42021277238). Genotyping data was based primarily on multilocus sequence types (STs) and Staphylococcal Cassette Chromosome mec (SCCmec) types. We utilized the Phyloviz algorithm in the cluster analysis and categorization of the MRSA STs into various clonal complexes (CCs).ResultsWe identified 65 studies and 26 publications from 16 of 54 (30%) African countries that provided sufficient genotyping data. MRSA with diverse staphylococcal protein A (spa) and SCCmec types in CC5 and CC8 were reported across the continent. The ST5-IV [2B] and ST8-IV [2B] were dominant clones in Angola and the Democratic Republic of Congo (DRC), respectively. Also, ST88-IV [2B] was widely distributed across the continent, particularly in three Portuguese-speaking countries (Angola, Cape Verde, and São Tomé and Príncipe). The ST80-IV [2B] was described in Algeria and Egypt, while the HA-ST239/ST241-III [3A] was only identified in Egypt, Ghana, Kenya, and South Africa. ST152-MRSA was documented in the DRC, Kenya, Nigeria, and South Africa. Panton–Valentine leukocidin (PVL)-positive MRSA was observed in several CCs across the continent. The median prevalence of PVL-positive MRSA was 33% (ranged from 0 to 77%; n = 15).ConclusionWe observed an increase in the distribution of ST1, ST22, and ST152, but a decline of ST239/241 in Africa. Data on MRSA clones in Africa is still limited. There is a need to strengthen genomic surveillance capacity based on a “One-Health” strategy to prevent and control MRSA in Africa.

show abstract

Panton-Valentine leukocidin–positive Staphylococcus aureus in skin and soft tissue infections from primary care patients

Cited by 11 publications

References 18 publications

Significant increase in the prevalence of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus , particularly the USA300 variant ΨUSA300, in the Japanese community

Significant increase in the prevalence of Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus , particularly the USA300 variant ΨUSA300, in the Japanese community

Epidemiology and clinical features of Skin and Soft Tissue Infections Caused by PVL-Positive and PVL-Negative Methicillin-Resistant Staphylococcus aureus Isolates in inpatients in China: a single-center retrospective 7-year study

A 6-Year Update on the Diversity of Methicillin-Resistant Staphylococcus aureus Clones in Africa: A Systematic Review

Contact Info

Product

Resources

About