title: The association between Staphylococcus aureus strains carrying panton-valentine leukocidin genes and the development of deep-seated follicular infection.
abstract: BACKGROUND
  Panton-Valentine leukocidin (PVL) is mainly associated with necrotic suppurative lesions, such as furuncles and abscesses in the skin and subcutaneous tissue, but it has also been isolated from patients with community-acquired, severe, necrotizing pneumonia. However, the clinical manifestations of furuncles caused by PVL-producing Staphylococcus aureus and the role of patients' background are not fully understood.
  
  
  METHODS
  We used polymerase chain reaction amplification to test for the PVL gene in 161 strains of S. aureus isolated from suppurative skin lesions. For all PVL gene-positive strains isolated from furuncles, we analyzed cutaneous manifestations, patient background characteristics, and bacteriological markers, including coagulase types, presence of the mecA gene, and toxin profiles, and we compared these results with those for PVL gene-negative strains.
  
  
  RESULTS
  PVL genes were detected in 16 (40%) of the 40 S. aureus strains isolated from furuncles, 2 (28%) of the 7 strains isolated from carbuncles, 1 (14%) of the 7 strains isolated from abscesses, and 1 (5%) of the 20 strains isolated from folliculitis. PVL gene-positive S. aureus usually causes multiple (rather than single) furuncles, and such furuncles are usually associated with more-intense erythema around the lesions. PVL gene-positive strains were isolated from young adults without underlying diseases, whereas PVL gene-negative strains were isolated from patients with various systemic complications, including diabetes, leukemia, and autoimmune diseases.
  
  
  CONCLUSIONS
  PVL gene-positive S. aureus strains are involved in the development of multiple furuncles with more-intense erythema, particularly in healthy young adults. An understanding of the characteristics of furuncles due to PVL gene-positive strains might be useful for preventing the development of the severe systemic infections.
authors.affiliation: Department of Dermatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, 700-8558, Japan. kota616@cc.okayama-u.ac.jp
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamasaki
authors.forename: Jun
authors.initials: J
authors.lastname: Kaneko
authors.forename: Shin
authors.initials: S
authors.lastname: Morizane
authors.forename: Hisanori
authors.initials: H
authors.lastname: Akiyama
authors.forename: Jirô
authors.initials: J
authors.lastname: Arata
authors.forename: Sachiko
authors.initials: S
authors.lastname: Narita
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Chiba
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kamio
authors.forename: Keiji
authors.initials: K
authors.lastname: Iwatsuki
mesh_terms: D000293:Adolescent; D000328:Adult; D001427:Bacterial Toxins / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D005098:Exotoxins / Q000235:genetics*; D006801:Humans; D007223:Infant; D007956:Leukocidins; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D013207:Staphylococcal Skin Infections / Q000382:microbiology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000235:genetics* / Q000472:pathogenicity*
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin