An invisible enemy: Panton-Valentine Leukocidin Staphylococcus Aureus on deployed troops

AbstractOver the last seven years Primary Care establishments in the Royal Navy and Royal Marines have dealt with a number of severe and fatal infections caused by Panton-Valentine leukocidin (PVL) producing Staphylococcus aureus, and appear to be seeing these infections more commonly than their civilian colleagues. This retrospective study looked at the levels of PVL S. aureus isolated in deployed personnel during Op HERRICK 14 to determine if the levels seen in British military troops are higher than the national average. We found that the percentage of PVL positive S. aureus isolates sent to the UK HPA reference laboratory from the Camp Bastion laboratory during OP Herrick 14 was 41%, considerably higher rate than the UK civilian rate. Future research, including a larger study into the carriage levels of PVL S. aureus in the military will hopefully shed more light on the spread and transmission of this potentially deadly bacterium.

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Infective skin conditions in an adult sea-going population

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-100-49 ◽

2014 ◽

Vol 100 (1) ◽

pp. 49-57

Author(s):

J Tanzer ◽

A Macdonald ◽

S Schofield

Keyword(s):

Primary Care ◽

Staphylococcus Aureus ◽

Military Personnel ◽

Family Doctor ◽

Soft Tissue Infections ◽

Close Proximity ◽

Skin Conditions ◽

The Uk ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

AbstractInfective skin conditions represent a significant element of the caseload for sea-going and shore-side clinicians. They are common within the wider military setting due to the frequent requirement to live in close proximity to others in conditions which favour the spread of skin and soft tissue infections (SSTI) (1, 2). Within the UK civilian population, 24% of individuals see their family doctor for skin conditions each year, accounting for 13 million primary care consultations annually. Of these, almost 900,000 were referred to dermatologists in England in 2009-2010 and resulted in 2.74 million secondary care consultations (3).Several recent articles have highlighted the problem of Panton-Valentine Leukocidin Staphylococcus aureus (PVL-SA) infection and carriage in sailors on submarines, and soldiers deployed to Afghanistan (4, 5). However, the majority of published articles relate to land-based military personnel. This article aims to provide an overview of the most common infective skin conditions presenting among Naval personnel (based on the authors’ experience), illustrated by several case studies, together with an approach to their diagnosis and management.

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"Panton-Valentine leukocidine"-producerende Staphylococcus aureus als belangrijke pathogeen voor purulente huidinfecties

Tijdschrift voor Geneeskunde ◽

10.47671/tvg.77.21.010 ◽

2021 ◽

Author(s):

L. DE LAET ◽

M. SCHELLEN ◽

M. DEPYPERE ◽

D. MARTINY ◽

M. HALLIN ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Adult Population ◽

Reference Laboratory ◽

Skin Infections ◽

National Guidelines ◽

Toxin Detection ◽

Reference Centre ◽

Invasive Infections ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

“Panton-Valentine leukocidin”- producing Staphylococcus aureus is an important pathogen of purulent skin and soft-tissue infections Staphylococcus aureus (S. aureus) colonises the skin, nose or throat in 20% to 30% of the adult population and is the most common pathogen causing mild to moderate skin infections. Panton-Valentine leukocidin (PVL) is an important virulence factor for S. aureus and plays a potential role in the pathogenesis of dermal necrosis. PVL is strongly associated with recurrent purulent skin infections and frequent need for surgical drainage. It is comparatively less common in colonisation and invasive infections (such as pneumonia, musculoskeletal disease and bacteraemia). The number of community-acquired PVLP-SA clones in Belgium remains stable since 2014. PVL-toxin detection in Belgium is limited to the National Reference Centre for S. aureus (LHUB-ULB, Brussels). Because of the limited indications for toxin testing and lack of impact on antibiotic therapy, there is currently no need for PVL-toxin detection outside the reference laboratory. On the other hand, increased awareness can lead to more efficient and systematic decolonisation policies and thereby reduce the risk of recurrent skin infections or outbreaks in (healthcare) institutions. In this case report followed by a literature review, we would like to inform all interested and involved clinicians (general practitioners, dermatologists, internists, paediatricians) about the national guidelines for PVL-toxin detection and the associated approach.

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Empyema thoracis secondary to community-acquired Panton-Valentine leukocidin (PVL) methicillin-resistant Staphylococcus aureus (MRSA) infection

BMJ Case Reports ◽

10.1136/bcr-2018-228297 ◽

2019 ◽

Vol 12 (4) ◽

pp. e228297 ◽

Cited By ~ 1

Author(s):

Shahbaz Piracha ◽

Syeda Saba Muneer Ahmed ◽

Samira Mohd Afzal ◽

Muhammad Badar Ganaie

Keyword(s):

Staphylococcus Aureus ◽

Outpatient Setting ◽

Empyema Thoracis ◽

Methicillin Resistant ◽

Public Health Challenges ◽

Invasive Infections ◽

Mrsa Infection ◽

The Uk ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

We report a case of a previously fit middle-aged man presenting to the outpatient setting with unilateral pleural effusion, with minimal symptoms. On subsequent investigations, he was diagnosed with empyema thoracis secondary to Panton-Valentine leukocidin (PVL)-toxin positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA). The patient was treated with prolonged antibiotics and pleural drainage, and he remained haemodynamically stable throughout hospital admission. PVL is a cytolytic exotoxin produced by some strains of S. aureus. Such strains often cause recurrent skin and soft tissue infections, usually in previously fit and healthy individuals. Less commonly, invasive infections occur; these carry a high mortality rate if associated with necrotising pneumonia or septic shock. PVL genes are present in approximately 2% of clinical isolates of S. aureus in the UK. PVL-producing MRSA infections are on the rise and present significant clinical and public health challenges.

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Panton-Valentine Leukocidin Staphylococcus Aureus (PVL-SA) – an uninvited stowaway aboard a Royal Navy submarine

Journal of The Royal Naval Medical Service ◽

10.1136/jrnms-99-3 ◽

2013 ◽

Vol 99 (1) ◽

pp. 3-8

Author(s):

SJN Bourn ◽

G Evans ◽

MK O’Shea

Keyword(s):

Public Health ◽

Staphylococcus Aureus ◽

Soft Tissue ◽

Virulence Factor ◽

Invasive Disease ◽

Soft Tissue Infections ◽

Royal Navy ◽

Military Populations ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

AbstractThe toxin Panton-Valentine Leukocidin (PVL) is a virulence factor produced by some strains of Staphylococcus aureus (S. aureus, SA) that destroys leucocytes. PVL-SA predominantly results in skin and soft tissue infections (SSTIs) but may also cause invasive disease, including necrotising pneumonia, which may affect healthy young individuals and has a high mortality. We describe a case of PVL-SA in a submariner who presented at sea and which resulted in a requirement to both alter the submarine’s programme and undertake population screening. The case highlights many important issues pertinent to military populations including clinical and public health considerations.

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