title: [Epidemiology and clinical presentation of Panton-Valentin leukocidin positive methicillin-resistant Staphylococcus aureus].
abstract: BACKGROUND
  the aim of our study was to review the epidemiology and clinical manifestations of infections due to Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus (PVL-MRSA).
  
  
  METHODS
  Medical history of patients infected by MRSA-PVL admitted to our hospital from January 2007 to July 2009 was reviewed. PVL and the type of cromosomic cassette were determined in all strains by PCR.
  
  
  RESULTS
  A total of 37 cases were included. Seventy percent were males and the median age was 39 years. Sixtytwo percent were Spanish, 14 (37.8%) were HIV-positive and 11 (29.7%) were homosexual. The source of the infection was the skin and soft tissue in 36 cases and pneumonia in 1. Sixteen patients were hospitalized, 5 had bacteremia and 5 developed septic metastasis. The relapse rate was 24% (9 cases). The prevalence during the study period was 11.2% of all MRSA isolated (37 out of 329). All the strains had a cromosomic cassette type IV and were susceptible to cotrimoxazole, rifampin, vancomyin, daptomycin and linezolid. The MIC of vancomycin, measured by E-test, was ≥ 1.5 mg/L in 28 out of 34 cases (82.3%).
  
  
  CONCLUSIONS
  Eleven percent of the MRSA strains isolated in our hospital are PVL positive. In general, skin and soft tissue infections are the most common and bacteremia or septic metastasis are frequent. In contrast to previous Spanish studies, more cases are observed in patients born in Spain and the infections are more severe.
authors.affiliation: Servicio de Enfermedades Infecciosas. Hospital Clínic de Barcelona, Barcelona.
authors.forename: N
authors.initials: N
authors.lastname: Cobos-Triguero
authors.forename: C
authors.initials: C
authors.lastname: Pitart
authors.forename: F
authors.initials: F
authors.lastname: Marco
authors.forename: J A
authors.initials: JA
authors.lastname: Martínez
authors.forename: M
authors.initials: M
authors.lastname: Almela
authors.forename: J
authors.initials: J
authors.lastname: López
authors.forename: M
authors.initials: M
authors.lastname: Ortega
authors.forename: A
authors.initials: A
authors.lastname: Soriano
authors.forename: J
authors.initials: J
authors.lastname: Mensa
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000150:complications / Q000382:microbiology; D001427:Bacterial Toxins / Q000494:pharmacology*; D005098:Exotoxins / Q000494:pharmacology*; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D007956:Leukocidins / Q000494:pharmacology*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018461:Soft Tissue Infections / Q000382:microbiology; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin