title: A history of Panton-Valentine leukocidin (PVL)-associated infection protects against death in PVL-associated pneumonia.
abstract: Panton-Valentine leukocidin (PVL) is a Staphylococcus aureus toxin associated with skin and soft-tissue infections (SSTIs) and life-threatening necrotizing pneumonia in humans. Recent reports have demonstrated that neutralizing antibody to PVL is not protective against SSTI recurrence, thus raising a controversy about the expected clinical benefits from the use of PVL as a vaccine target. To investigate the impact of pre-existing immunity to PVL on the outcome of necrotizing pneumonia, we conducted a retrospective study of 114 cases and searched for an association between the history of PVL-associated infection and outcome. Death and severity factors, such as the need for mechanical ventilation and inotrope support, were significantly less frequent in patients with prior PVL-associated infection than in those without. These findings indicate a protective role of PVL-directed immunity in severe systemic PVL-associated disease, suggesting that anti-PVL vaccine could provide strong clinical benefits in this setting.
authors.affiliation: INSERM U851, National Reference Center for Staphylococci, University of Lyon, Lyon, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Rasigade
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sicot
authors.forename: Frederic
authors.initials: F
authors.lastname: Laurent
authors.forename: Gerard
authors.initials: G
authors.lastname: Lina
authors.forename: François
authors.initials: F
authors.lastname: Vandenesch
authors.forename: Jerome
authors.initials: J
authors.lastname: Etienne
mesh_terms: D001427:Bacterial Toxins / Q000276:immunology*; D005098:Exotoxins / Q000276:immunology*; D006801:Humans; D007956:Leukocidins / Q000276:immunology*; D011023:Pneumonia, Staphylococcal / Q000276:immunology / Q000401:mortality* / Q000517:prevention & control*; D015995:Prevalence; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013211:Staphylococcus aureus / Q000276:immunology* / Q000472:pathogenicity*; D037521:Virulence Factors / Q000276:immunology*
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D037521:Virulence Factors