title: Frequency and clinical association of Panton-Valentine leukocidin-positive Staphylococcus aureus isolates: a study from Kuwait.
abstract: OBJECTIVE
  This study was undertaken to determine the frequency of Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus among strains isolated in our laboratory and to study the association of PVL-positive strains with clinical disease.
  
  
  METHODS
  A total of 291 S. aureus isolates obtained from different clinical specimens from June 1, 2009, to March 31, 2010, at the Farwania Hospital Laboratory were investigated for antimicrobial susceptibility, carriage of genes for PVL, and SCCmec elements. Antimicrobial susceptibility testing was performed by standard methods. The presence of mecA genes for PVL SCCmec typing was determined by PCR.
  
  
  RESULTS
  Of the 291 S. aureus isolates, 89 (30.6%) were methicillin-resistant S. aureus (MRSA), whereas 202 (69.4%) were methicillin susceptible (MSSA). Genes for PVL were detected in 13 (14.6%) and 24 (12.0%) of the MRSA and MSSA isolates, respectively. The majority of the PVL-producing MRSA and MSSA were isolated from 12 (30.7%) and 19 (21.8%) cases of skin and soft tissue infections (SSTI), respectively. Although both MSSA and MRSA strains were uniformly susceptible to rifampicin, teicoplanin, and vancomycin, multidrug resistance was observed among PVL-producing and nonproducing MRSA isolates. Both MRSA types carried SCCmec type III, IV, IVc, and V genetic elements.
  
  
  CONCLUSIONS
  This study revealed the presence of genes for PVL in both MSSA and MRSA, associated mostly with SSTI and respiratory tract infections, supporting previous observations that PVL production is widespread among S. aureus strains obtained from different clinical sources.
authors.affiliation: Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania, Kuwait. ilh_g@hotmail.com
authors.forename: Wadha
authors.initials: W
authors.lastname: AlFouzan
authors.forename: Aneesah
authors.initials: A
authors.lastname: Al-Haddad
authors.forename: Edet
authors.initials: E
authors.lastname: Udo
authors.forename: Bindu
authors.initials: B
authors.lastname: Mathew
authors.forename: Rita
authors.initials: R
authors.lastname: Dhar
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000235:genetics / Q000302:isolation & purification*; D001431:Bacteriological Techniques; D004269:DNA, Bacterial / Q000235:genetics; D005098:Exotoxins / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007730:Kuwait / Q000453:epidemiology; D007956:Leukocidins / Q000235:genetics / Q000302:isolation & purification*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D046915:Penicillin-Binding Proteins; D012141:Respiratory Tract Infections / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D046915:Penicillin-Binding Proteins; C108483:leukocidin S-component protein, Staphylococcus; C487789:mecA protein, Staphylococcus aureus; C074300:LukF protein, Staphylococcus aureus