Frequent carriage of Panton-Valentine leucocidin genes by Staphylococcus aureus isolates from surgically drained abscesses.
Between 1 February and 15 April 2002, 95 patients were admitted to Gaston Bourret Territorial Hospital (New Caledonia, France) for drainage of community-acquired soft tissue abscesses. Staphylococcus aureus was detected in 68 cases (72%). Two-thirds of the patients with S. aureus infection had furuncles, which were located on the limbs in 82% of cases. The median interval between symptom onset and hospital admission was 5.7 days. Three-quarters of the patients were Melanesians living in tribes. Fifty-four S. aureus isolates were screened for toxin genes. Panton-Valentine leucocidin (PVL) genes were detected in 48 isolates (89%), the exfoliative toxin A gene was detected in 1 isolate, and no toxin genes were detected in 4 isolates. S. aureus nasal carriage was detected in 39.7% of patients with S. aureus infections. Two infecting S. aureus strains and two nasal carriage strains were resistant to methicillin. Comparative pulsed-field gel electrophoresis, performed in 16 cases, showed that five of six patients with PVL-positive nasal carriage strains were infected by the same strains. In contrast, 8 of 10 patients with PVL-negative nasal carriage strains were infected by PVL-positive strains. PVL genes thus appear to be a major virulence factor in both primary and secondary S. aureus skin infections.
Department of Internal Medicine and Infectious and Tropical Diseases, C.H.T Gaston Bourret, Nouméa, Nouvelle Calédonie, France.
Bertrand
B
Issartel
Anne
A
Tristan
Sylvain
S
Lechevallier
Franck
F
Bruyère
Gerard
G
Lina
Benoît
B
Garin
Flore
F
Lacassin
Michèle
M
Bes
François
F
Vandenesch
Jerome
J
Etienne
D000038:Abscess / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D001427:Bacterial Toxins; D002353:Carrier State / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000382:microbiology; D005098:Exotoxins; D005260:Female; D006801:Humans; D007956:Leukocidins / Q000235:genetics*; D008297:Male; D009666:Nose / Q000382:microbiology; D018461:Soft Tissue Infections / Q000382:microbiology* / Q000601:surgery; D013207:Staphylococcal Skin Infections / Q000382:microbiology* / Q000601:surgery; D013211:Staphylococcus aureus / Q000235:genetics* / Q000302:isolation & purification
D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin