#82: Osteomyelitis with Panton-Valentine Leukocidin Producing Staphylococcus aureus Strains, Experience in a Tertiary Pediatric Hospital in Mexico City

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S9-S9
Author(s):  
Nancy Aguilar ◽  
Alejandra Aquino ◽  
Guillermo Vázquez ◽  
Jocelin Mérida ◽  
Oscar Isunza-Alonso ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Mexico City ◽  
Clinical Features ◽  
Methicillin Resistance ◽  
Tertiary Hospital ◽  
Antimicrobial Treatment ◽  
High Rate ◽  
Critical Event ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

Abstract Background S. aureus is the most common cause of osteomyelitis in children. Panton-Valentine leucocidin (PVL) is an exotoxin produced by certain S. aureus strains, which can be detected in both methicillin-sensitive and -resistant strains of staphylococci. Pediatric osteomyelitis by PVL producing S. aureus constitute a rare, but highly critical event. They are characterized by a rapid course of marked inflammation, worsening under conservative therapy, and a high rate of recurrence. No information is available on osteomyelitis and Panton-Valentine leukocidin producing S. aureus in Mexico. Objective The aim of this study was to determine the molecular characterization of S. aureus strains isolated in pediatric patients with osteomyelitis and their clinical features in a tertiary hospital in Mexico City. Methods We conducted a prospective study of children admitted for osteomyelitis, between December 2018 and November 2019, at Instituto Nacional de Pediatría. We obtained an informed consent in children under 12 years of age and an informed assent in children over 12. The confirmation of the S. aureus isolates was performed by amplification and analysis of 16S rRNA and nuc genes. The mecA and pvl genes were detected by PCR, the clinical features were obtained at the admission. Results Fifty patients were included and 26 cases of osteomyelitis were diagnosed, 13 were due to staphylococcus aureus genus and 6 due to S. aureus; all of them were methicillin susceptible and two were PVL producers. Both patients had a severe initial presentation, with extensive local abscesses, and one required three surgical procedures and developed septic pulmonary embolism. The two patients received double antimicrobial treatment and required a long therapy interval. Conclusions Osteomyelitis with Panton-Valentine Leukocidin producing S. aureus seems to be more severe. In patients with severe osteomyelitis, it is essential to detect the PVL toxin because they require early surgical intervention and prolonged intravenous therapy. Our findings suggest that the severity of the osteomyelitis is linked with PVL production more than with methicillin resistance due to that all our isolates were methicillin susceptible.

scholarly journals Panton-Valentine Leukocidin-Producing Staphylococcus aureus Infection: A Case Series

2020 ◽  
Vol 12 (3) ◽  
pp. 61-69
Author(s):  
Beatriz Prista-Leão ◽  
Isabel Abreu ◽  
Raquel Duro ◽  
André Silva-Pinto ◽  
Filipa Ceia ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Case Series ◽  
Adult Males ◽  
Gene Search ◽  
Physician Awareness ◽  
Travel Abroad ◽  
Adequate Management ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) is associated with relapsing multifocal skin and soft tissue infections (SSTI), necrotizing pneumonia (NP) and severe musculoskeletal infections. Epidemiology is underknown and underdiagnosis is likely. Recent travel abroad, case clustering and relapsing disease are often reported. We reviewed all cases of PVL-SA infection diagnosed at our center, and found 21 cases over a 43-month period. Most patients were adult males, had relevant travel history, reported recurrent disease and presented with SSTI. Etiologic diagnosis took up to five years; meanwhile, 42% of patients had antibiotic treatments. Draining procedures were required in 43% of patients and intensive care support in 19%. All patients recovered. Methicillin-resistance prevalence was 24%. Only 2/13 decolonized patients had posterior relapsing SSTI, both with likely infected contacts. PVL-SA infection’s severity and impact are clear, even in small case series as ours. Physician awareness and active PVL-gene search are crucial for an adequate management.

scholarly journals The Role of Staphylococcus aureus in Mastitis

2019 ◽  
Vol 36 (3) ◽  
pp. 503-509 ◽  
Author(s):  
Sara Giordana Rimoldi ◽  
Paola Pileri ◽  
Martina Ilaria Mazzocco ◽  
Francesca Romeri ◽  
Giovanna Bestetti ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Median Number ◽  
Clinical Severity ◽  
Toxin Gene ◽  
Lactation Period ◽  
Breast Abscess ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

Background Breastfeeding women are at risk of developing mastitis during the lactation period. Staphylococcus aureus has emerged as the community-acquired pathogen responsible for virulence (methicillin resistance and Panton-Valentine leukocidin toxin producing). Research aim The aim was to compare the microorganisms responsible for mastitis and breast abscesses during breastfeeding. Methods This observational study was conducted with a sample of women ( N = 60) admitted to our hospital between 2016 and 2018. Participants affected by mastitis and breast abscess were studied and cared for by a multidisciplinary working group. A diagnostic breast ultrasound identified the pathology. Results Twenty-six participants (43.3%) were affected by mastitis and 34 (56.7%) by breast abscess. The most common microorganism identified was Staphylococcus aureus ( S. aureus; mastitis, n = 13; abscesses, n = 24). Methicillin resistance was identified in 21 (44.7%) S. aureus strains: 17 (80.9%) cases of abscess and four (19.1%) cases of mastitis. The median number of months of breastfeeding was smaller in the methicillin-resistant S. aureus (MRSA) cases (median = 3, range = 1–20 months) than in the methicillin-sensitive S. aureus (MSSA) cases (median = 6.5, range = 3–21 months). The Panton-Valentine leukocidin toxin gene was detected in 12 (25.5%) cases (MRSA, n = 8, 66.7%; MSSA, n = 4, 33.3%). Hospitalization was required more frequently in MRSA ( n = 8, 38%; five Panton-Valentine leukocidin positive) than in MSSA cases ( n = 5, 19%; one Panton-Valentine leukocidin positive). Four women out of the eight MRSA cases (50%) that were Panton-Valentine leukocidin positive stopped breastfeeding during mammary pathologies, three (37.5%) participants continued breastfeeding until the follow-up recall, and one case was lost at follow-up. Conclusion Clinical severity was probably complicated by the presence of the Panton-Valentine leukocidin toxin, which required hospitalization more frequently.

Panton-Valentine Leukocidin Gene Detected in a Staphylococcus Aureus Strain Isolated from a Knee Arthroprosthesis Infection

2009 ◽  
Vol 32 (9) ◽  
pp. 630-634 ◽  
Author(s):  
Lucio Montanaro ◽  
Lucilla Baldassarri ◽  
Tolmino Corazzari ◽  
Roberta Creti ◽  
Stefano Ravaioli ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Meca Gene ◽  
Research Unit ◽  
Aureus Strain ◽  
Toxin Gene ◽  
Strain Collection ◽  
Rizzoli Orthopaedic Institute ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

This report focuses on the molecular characterization of a Staphylococcus aureus strain isolated from a knee arthroprosthesis infection and recognized retrospectively as a carrier of the Panton-Valentine leukocidin gene. The stored microbiological isolate, which belonged to the strain collection of the Research Unit on Implant Infections of the Rizzoli Orthopaedic Institute, was retrieved for molecular analysis. Genotyping was carried out, revealing an interesting profile. In addition to the positivity for the Panton-Valentine toxin gene, the results indicated that the isolate belonged to the agr III group and was endowed with bbp and cna genes, both encoding for staphylococcal adhesins that bind bone proteins. The strain had the mecA gene for methicillin resistance, even though it was unable to resist any of the β-lactam or other antibiotics. Its gene configuration matched that of other community-acquired methicillin-resistant and methicillin-susceptible Staphylococcus aureus (CA-MRSA and CA-MSSA) strains which have recently been reported worldwide. As far as we know, this is the first report on a PVL-positive S. aureus strain associated with an orthopedic implant (knee arthroprosthesis) infection.

Population dynamics ofStaphylococcus aureusfrom Northeastern Nigeria in 2007 and 2012

2013 ◽  
Vol 142 (8) ◽  
pp. 1737-1740 ◽  
Author(s):  
K. O. OKON ◽  
A. O. SHITTU ◽  
A. A. KUDI ◽  
H. UMAR ◽  
K. BECKER ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Population Structure ◽  
Methicillin Resistance ◽  
Significant Decline ◽  
Sub Saharan Africa ◽  
Resistance To Penicillin ◽  
Sub Saharan ◽  
Resistance Rates ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

SUMMARYThe population structure ofStaphylococcus aureusis changing globally but the situation regarding dominant clones in sub-Saharan Africa is not clear. We therefore assessed changes in the population structure of clinicalS. aureusisolates obtained in 2007 (n = 75) and 2012 (n = 75) from Northeastern Nigeria. A reduction in resistance to penicillin, gentamicin, erythromycin and clindamycin was observed in 2012. A decrease of methicillin resistance rates (13·3% to 8·0%) was associated with the decline of the ST241 MRSA clone. The proportion of Panton–Valentine leukocidin (PVL)-positive isolates also decreased from 65·3% to 44%, and was linked with the emergence of PVL-negative ST601 clone in 2012. The significant decline in antibiotic resistance in the study area is in contrast to the worldwide trend of increasing resistance rates.

Staphylococcus aureus abscesses: methicillin-resistance or Panton-Valentine leukocidin presence?

2013 ◽  
Vol 98 (8) ◽  
pp. 608-610 ◽  
Author(s):  
M. Barrios Lopez ◽  
C. Gomez Gonzalez ◽  
M. A. Orellana ◽  
F. Chaves ◽  
P. Rojo
Keyword(s):  
Staphylococcus Aureus ◽  
Methicillin Resistance ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin
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