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

“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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Panton–Valentine leukocidin Staphylococcus aureus osteomyelitis of the adult tibia – a case report

Annals of The Royal College of Surgeons of England ◽

10.1308/147870810x476719 ◽

2010 ◽

Vol 92 (2) ◽

pp. e17-e19 ◽

Cited By ~ 3

Author(s):

MJ Hall ◽

JA Steer ◽

J Keenan

Keyword(s):

Staphylococcus Aureus ◽

Case Report ◽

Soft Tissue ◽

Surgical Management ◽

Adult Male ◽

Soft Tissue Infections ◽

Musculoskeletal Infection ◽

Invasive Infections ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

Panton–Valentine leukocidin toxin producing Staphylococcus aureus (PVLSA) is known to be responsible for recurrent soft tissue infections and more serious invasive infections including necrotising pneumonia, pyomyositis, and osteomyelitis. Most reported cases involving musculoskeletal infection in adults are associated with methicillin-resistant S. aureus (MRSA) PVL-producing strains. We present the case of an adult male with PVL toxin–producing methicillin-sensitive S. aureus (MSSA) osteomyelitis of the tibia which has not previously been described in adults and highlight issues of recognition, treatment, and surgical management of PVLSA osteomyelitis.

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Prevalence of skin infections caused by Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus in Japan, particularly in Ishigaki, Okinawa

Journal of Infection and Chemotherapy ◽

10.1016/j.jiac.2017.04.016 ◽

2017 ◽

Vol 23 (11) ◽

pp. 800-803 ◽

Cited By ~ 20

Author(s):

Shunsuke Takadama ◽

Hidemasa Nakaminami ◽

Sae Aoki ◽

Megumi Akashi ◽

Takeaki Wajima ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Skin Infections ◽

Methicillin Resistant ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

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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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Virulent MRSA strains containing the Panton Valentine Leukocidin gene in the Netherlands

Weekly releases (1997–2007) ◽

10.2807/esw.07.10.02173-en ◽

2003 ◽

Vol 7 (10) ◽

Cited By ~ 1

Author(s):

W J B Wannet

Keyword(s):

Los Angeles ◽

The Netherlands ◽

The United States ◽

Reference Laboratory ◽

Skin Infections ◽

Healthcare Staff ◽

Gay Community ◽

Mrsa Strains ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

Methicillin resistant Staphylococcus aureus (MRSA) strains possessing the Panton Valentine Leukocidin (PVL) gene have been detected in the Netherlands recently. The PVL gene encodes a highly potent toxin, which is involved in severe skin infections and necrotising pneumonia. PVL positive MRSA strains have also been noted in France (in healthy individuals; mean age 14 years), in the United States (for example, in the Los Angeles gay community, and in a large prison), and in Scotland (small outbreaks of skin abscesses in healthcare staff. The Scottish MRSA reference laboratory is now routinely screening both methicillin susceptible S. aureus (MSSA) and MRSA for the PVL gene). It has been suggested that the PVL MRSA is acquired in the community (1-3).

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Panton-Valentine Leukocidin-Positive Methicillin-Resistant Staphylococcus Aureus with Reduced Vancomycin Susceptibility: An Emerging Trend?

Medical University ◽

10.2478/medu-2020-0020 ◽

2020 ◽

Vol 3 (4) ◽

pp. 165-181

Author(s):

Tatsuo Yamamoto ◽

Olga E. Khokhlova ◽

Tsai-Wen Wan ◽

Darya N. Akhusheva ◽

Ivan V Reva ◽

...

Keyword(s):

Staphylococcus Aureus ◽

The United States ◽

Multidrug Resistant ◽

Virus Infections ◽

Methicillin Resistant ◽

Invasive Infections ◽

Spread Factor ◽

Healthcare Associated ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

AbstractMethicillin-resistant Staphylococcus aureus (MRSA) is a major multidrug-resistant nosocomial pathogen. This class of MRSA, first reported in the early 1960s and now termed healthcare-associated MRSA (HA-MRSA), was followed by a newer class of MRSA, community-associated MRSA (CA-MRSA). The unique feature of the initial CAMRSA included Panton-Valentine leukocidin (PVL), an abscess-associated toxin and also S. aureus spread factor. CA-MRSA usually causes skin and soft-tissue infections, but occasionally causes invasive infections, including (necrotizing) pneumonia, sometimes preceded by respiratory virus infections. The most successful CA-MRSA USA300 (ST8/SCCmecIVa) caused an epidemic in the United States. In Russia, we first detected PVL-positive CAMRSA (ST30/SCCmecIVc) in Vladivostok in 2006, but with no more PVL-positive MRSA isolation. However, we recently isolated four lineages of PVL-positive MRSA in Krasnoyarsk. Regarding chemotherapy against invasive MRSA infections, vancomycin still remains a gold standard, in addition to some other anti-MRSA agents such as teicoplanin, linezolid, and daptomycin. For resistance, vancomycin-resistant MRSA (VRSA) with MICs of ≥16 μg/mL appeared in patients, but cases are still limited. However, clinically, infections from strains with MICs of ≥1.5 μg/mL, even albeit with susceptible MICs (≤2 μg/mL), respond poorly to vancomycin. Some of those bacteria have been bacteriologically characterized as vancomycin-intermediate S. aureus (VISA) and heterogeneous VISA (hVISA), generally with HA-MRSA genetic backgrounds. The features of the above PVL-positive Krasnoyarsk MRSA include reduced susceptibility to vancomycin, which meets the criteria of hVISA. In this review, we discuss a possible new trend of PVL-positive hVISA, which may spread and threaten human health in community settings.

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Community-Associated Methicillin-ResistantStaphylococcus aureusLacking PVL, as a Cause of Severe Invasive Infection Treated with Linezolid

Case Reports in Pediatrics ◽

10.1155/2013/727824 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Catarina Gouveia ◽

Alexandra Gavino ◽

Ons Bouchami ◽

Maria Miragaia ◽

Luis Varandas ◽

...

Keyword(s):

Public Health ◽

Staphylococcus Aureus ◽

Synovial Fluid ◽

Public Health Problem ◽

Invasive Infection ◽

Limited Information ◽

Invasive Infections ◽

Sport Athlete ◽

Panton Valentine Leukocidin ◽

Valentine Leukocidin

Community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) is an emerging public health problem worldwide. Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL). In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia. The MRSA isolated from blood and synovial fluid was PVL negative and staphylococcal enterotoxin type P (SEP) and type L (SEL) positive, with a vancomycin MIC of 1.0 mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted to multiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused by CA-MRSA in Portugal, which was successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.

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