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Kirkliauskienė A, Kriščiūnas J, Miciulevičienė J, Radzišauskienė D, Kačergius T, Bratchikov M, Kaplerienė L. Antimicrobial Resistance and the Prevalence of the Panton-Valentine Leukocidin Gene among Clinical Isolates of Staphylococcus aureus in Lithuania. Pol J Microbiol 2024; 73:21-28. [PMID: 38437463 PMCID: PMC10911699 DOI: 10.33073/pjm-2024-003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/18/2023] [Indexed: 03/06/2024] Open
Abstract
This study aimed to determine resistance to antimicrobials of Staphylococcus aureus strains isolated from clinical specimens in Lithuanian hospitals and to identify the genes conferring resistance and virulence. The study was carried out from June 2019 to September 2021. S. aureus strains were isolated from skin, soft tissues, blood, lower respiratory tract, urine and other specimens. Antibiotic susceptibility testing was performed using the disc diffusion method according to EUCAST guidelines. All isolates were analyzed for detection of the ermA, ermC, mecA, mecC, tetK, tetM, and lukF-PV genes by multiplex real-time PCR. The 16S rRNA coding sequence was applied as an internal PCR control. Altogether, 745 S. aureus strains were analyzed. Antimicrobial susceptibility testing revealed that all isolates were susceptible to rifampin and vancomycin. Of the 745 strains, 94.8% were susceptible to tetracycline, 94.5% to clindamycin, and 88.3% to erythromycin. The lowest susceptibility rate was found for penicillin (25.8%). Six percent of the tested strains were methicillin-resistant S. aureus (MRSA). The majority of methicillin-resistant strains were isolated from skin and soft tissues (73.3%), with a smaller portion isolated from blood (17.8%) and respiratory tract (8.9%). The ermC gene was detected in 41.1% of erythromycin-resistant S. aureus strains, whereas ermA was detected in 32.2% of erythromycin-resistant S. aureus strains. 69.2% of tetracycline-resistant S. aureus strains had tetK gene, and 28.2% had tetM gene. 7.3% of S. aureus isolates harbored lukF-PV gene. The frequency of the pvl gene detection was significantly higher in MRSA isolates than in methicillin-susceptible S. aureus isolates (p < 0.0001).
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Affiliation(s)
- Agnė Kirkliauskienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - Daiva Radzišauskienė
- Department of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Tomas Kačergius
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Maksim Bratchikov
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Lina Kaplerienė
- Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Savin A, Anderson EE, Dyzenhaus S, Podkowik M, Shopsin B, Pironti A, Torres VJ. Staphylococcus aureus senses human neutrophils via PerR to coordinate the expression of the toxin LukAB. Infect Immun 2024; 92:e0052623. [PMID: 38235972 PMCID: PMC10863418 DOI: 10.1128/iai.00526-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/19/2024] Open
Abstract
Staphylococcus aureus is a gram-positive pathogen that poses a major health concern, in part due to its large array of virulence factors that allow infection and evasion of the immune system. One of these virulence factors is the bicomponent pore-forming leukocidin LukAB. The regulation of lukAB expression is not completely understood, especially in the presence of immune cells such as human polymorphonuclear neutrophils (hPMNs). Here, we screened for transcriptional regulators of lukAB during the infection of primary hPMNs. We uncovered that PerR, a peroxide sensor, is vital for hPMN-mediated induction of lukAB and that PerR upregulates cytotoxicity during the infection of hPMNs. Exposure of S. aureus to hydrogen peroxide (H2O2) alone also results in increased lukAB promoter activity, a phenotype dependent on PerR. Collectively, our data suggest that S. aureus uses PerR to sense the H2O2 produced by hPMNs to stimulate the expression of lukAB, allowing the bacteria to withstand these critical innate immune cells.IMPORTANCEStaphylococcus aureus utilizes a diverse set of virulence factors, such as leukocidins, to subvert human neutrophils, but how these toxins are regulated is incompletely defined. Here, we identified the peroxide-sensitive repressor, PerR, as a required protein involved in the induction of lukAB in the presence of primary human neutrophils, a phenotype directly linked to the ability of PerR to sense H2O2. Thus, we show that S. aureus coordinates sensing and resistance to oxidative stress with toxin production to promote pathogen survival.
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Affiliation(s)
- Avital Savin
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
- Department of Biology, New York University, New York, New York, USA
| | - Exene E. Anderson
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Sophie Dyzenhaus
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Magdalena Podkowik
- Antimicrobial-Resistant Pathogens Program, New York University Grossman School of Medicine, New York, New York, USA
- Division of Infectious Diseases, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Bo Shopsin
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
- Antimicrobial-Resistant Pathogens Program, New York University Grossman School of Medicine, New York, New York, USA
- Division of Infectious Diseases, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Alejandro Pironti
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
- Antimicrobial-Resistant Pathogens Program, New York University Grossman School of Medicine, New York, New York, USA
| | - Victor J. Torres
- Department of Microbiology, New York University Grossman School of Medicine, New York, New York, USA
- Department of Host-Microbe Interactions, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
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Jhelum H, Čerina D, Harbort CJ, Lindner A, Hanitsch LG, Leistner R, Schröder JT, von Bernuth H, Stegemann MS, Schürmann M, Zychlinsky A, Krüger R, Marsman G. Panton-Valentine leukocidin-induced neutrophil extracellular traps lack antimicrobial activity and are readily induced in patients with recurrent PVL + -Staphylococcus aureus infections. J Leukoc Biol 2024; 115:222-234. [PMID: 37943843 DOI: 10.1093/jleuko/qiad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023] Open
Abstract
Staphylococcus aureus strains that produce the toxin Panton-Valentine leukocidin (PVL-SA) frequently cause recurrent skin and soft tissue infections. PVL binds to and kills human neutrophils, resulting in the formation of neutrophil extracellular traps (NETs), but the pathomechanism has not been extensively studied. Furthermore, it is unclear why some individuals colonized with PVL-SA experience recurring infections whereas others are asymptomatic. We thus aimed to (1) investigate how PVL exerts its pathogenicity on neutrophils and (2) identify factors that could help to explain the predisposition of patients with recurring infections. We provide genetic and pharmacological evidence that PVL-induced NET formation is independent of NADPH oxidase and reactive oxygen species production. Moreover, through NET proteome analysis we identified that the protein content of PVL-induced NETs is different from NETs induced by mitogen or the microbial toxin nigericin. The abundance of the proteins cathelicidin (CAMP), elastase (NE), and proteinase 3 (PRTN3) was lower on PVL-induced NETs, and as such they were unable to kill S. aureus. Furthermore, we found that neutrophils from affected patients express higher levels of CD45, one of the PVL receptors, and are more susceptible to be killed at a low PVL concentration than control neutrophils. Neutrophils from patients that experience recurring PVL-positive infections may thus be more sensitive to PVL-induced NET formation, which might impair their ability to combat the infection.
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Affiliation(s)
- Hina Jhelum
- Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117, Berlin, Germany
| | - Dora Čerina
- Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117, Berlin, Germany
| | - C J Harbort
- Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117, Berlin, Germany
| | - Andreas Lindner
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Leif Gunnar Hanitsch
- Department of Medical Immunology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Rasmus Leistner
- Institute of Hygiene and Environmental Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Jennyver-Tabea Schröder
- Department of Pediatric Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Department of Immunology, Labor Berlin GmbH, Sylter Straße 2, 13353, Berlin, Germany
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Miriam Songa Stegemann
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Mariana Schürmann
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Arturo Zychlinsky
- Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117, Berlin, Germany
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Gerben Marsman
- Department of Cellular Microbiology, Max Planck Institute for Infection Biology, Charitéplatz 1, 10117, Berlin, Germany
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Nor Amdan NA, Zamri HF, Mohd Ali MR, Dahalan NA, Anak Maling DR, Wan Hamdan WAF, Che Unik NSI, Mohd Rof PHS, Hashim R, Ahmad N. Predominance of SCCmec type IV in community-acquired meticillin-resistant Staphylococcus aureus (MRSA) in multi-centre Malaysian hospitals. J Hosp Infect 2024; 143:113-114. [PMID: 37979625 DOI: 10.1016/j.jhin.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/20/2023]
Affiliation(s)
- N A Nor Amdan
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia.
| | - H F Zamri
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - M R Mohd Ali
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - N A Dahalan
- National Blood Centre, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - D R Anak Maling
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - W A F Wan Hamdan
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - N S I Che Unik
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - P H S Mohd Rof
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - R Hashim
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
| | - N Ahmad
- Bacteriology Unit, Infectious Disease Research Centre (IDRC), Institute for Medical Research (IMR), National Institutes of Health, Selangor, Malaysia
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Balakirski G, Hofmann SC. [Genitoanal infections caused by Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus : Smear infection or sexually transmitted disease?]. Dermatologie (Heidelb) 2024; 75:55-60. [PMID: 37982858 DOI: 10.1007/s00105-023-05255-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/19/2023] [Indexed: 11/21/2023]
Abstract
Panton-Valentine leukocidin (PVL) is a pore-forming exotoxin produced by certain Staphylococcus (S.) aureus strains, which is responsible for the increased virulence of the pathogen. Thus, infections caused by PVL-positive S. aureus tend to recur. Usually, the infection is a smear infection, which can cause folliculitis and purulent lid margin inflammation in addition to the classic mucocutaneous abscesses. Recently, recurrent genitoanal infections caused by PVL-positive S. aureus have also been described. In most cases, this is a sexually transmitted disease. Currently, it is assumed that most infections are imported from abroad. In addition to treatment of these infections, decolonization should be performed for prophylaxis of recurrence.
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Affiliation(s)
- Galina Balakirski
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland.
| | - Silke C Hofmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Universitätsklinikum Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Deutschland
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Li X, Li G, Huang H, Wan P, Lu Y, Li Z, Xie L, Xiong W, Zeng Z. The occurrence and contamination of optrA-positive methicillin-resistant Staphylococcus aureus from duck farms in Guangdong, China. J Glob Antimicrob Resist 2023; 35:86-92. [PMID: 37689309 DOI: 10.1016/j.jgar.2023.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
OBJECTIVES Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), is an important zoonotic microorganism that increasingly causes public health concern worldwide. The objective of this study was to determine the prevalence and transmission of S. aureus in duck farms and evaluate its antimicrobial resistance and genetic characteristics. METHODS The samples associated with ducks, feeders, and the environment were collected on 14 duck farms from four areas in Guangdong, China, from 2020 to 2021. All isolates were subjected to antimicrobial susceptibility testing. A comprehensive epidemiological survey of S. aureus was conducted by S. aureus protein A typing and whole-genome sequencing. RESULTS A total of 560 samples were collected. The prevalence rate of MRSA among ducks (8.1%, 11 of 135) was higher compared with that in environmental samples. OptrA-positive ST398-t034 MRSA were first detected from duck farms in China. A total of 79.3% (34 of 46) S. aureus isolates showed multidrug-resistant phenotypes. Notably, some isolates carried multidrug-resistant genes encoding macrolide-lincosamide-streptogramin B, pleuromutilin-pleuromutilin-streptogramin A, and oxazolidinone. Analysis of the virulence genes revealed that the MRSA isolates carried genes encoding gamma-hemolysin, enterotoxin, and leukocidin. ST9-t899 is a primary clonal lineage among duck- and environment-associated MRSA. Single-nucleotide polymorphism analysis showed the potential contamination relationship of optrA-positive ST2308 MRSA isolates carrying the gamma-hemolysin genes and the leukocidin virulence genes between airborne dust and sick ducks. CONCLUSION The contamination of MRSA, especially optrA-positive MRSA, between food animals and the environment is a growing public health concern worldwide. Based on One Health principles, continuous surveillance of MRSA is urgently needed.
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Affiliation(s)
- Xiaoshen Li
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Guihua Li
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Honghao Huang
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Peng Wan
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Yixing Lu
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Zhi Li
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Longfei Xie
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Wenguang Xiong
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China
| | - Zhenling Zeng
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China; National Risk Assessment Laboratory for Antimicrobial Resistance of Animal Original Bacteria, South China Agricultural University, Guangzhou, China; National Laboratory of Safety Evaluation (Environmental Assessment) of Veterinary Drugs, South China Agricultural University, Guangzhou, China.
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Lee GY, Lee SI, Park JH, Kim SD, Kim GB, Yang SJ. Detection and characterization of potential virulence determinants in Staphylococcus pseudintermedius and S. schleiferi strains isolated from canine otitis externa in Korea. J Vet Sci 2023; 24:e85. [PMID: 38031521 PMCID: PMC10694376 DOI: 10.4142/jvs.23087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND A recent increase in the occurrence of canine skin and soft tissue infections, including otitis externa and pyoderma, caused by antimicrobial-resistant Staphylococcus pseudintermedius and S. schleiferi has become a significant public and veterinary health issues. OBJECTIVE We investigated the virulence potentials associated with the occurrence of canine otitis externa in S. pseudintermedius and S. schleiferi. METHODS In this study, the prevalence of genes encoding leukocidins, exfoliative toxins, and staphylococcal enterotoxins (SEs) was investigated using previously characterized S. pseudintermedius (n = 26) and S. schleiferi (n = 19) isolates derived from canine otitis externa. Susceptibility to cathelicidins (K9CATH and PMAP-36) and hydrogen peroxide (H2O2) was also examined in both staphylococcal species. RESULTS A high prevalence of genes encoding leukocidins (lukS/F-I, lukS1/F1-S, and lukS2/F2-S), exfoliative toxins (siet, expB, and sset), and SEs was identified in both S. pseudintermedius and S. schleiferi isolates. Notably, S. pseudintermedius isolates possessed higher number of SE genes, especially newer SE genes, than S. schleiferi isolates harboring egc clusters. Although no significant differences in susceptibility to K9CATH and H2O2 were observed between the two isolate groups, S. pseudintermedius isolates exhibited enhanced resistance to PMAP-36 compared to S. schleiferi isolates. CONCLUSIONS These findings suggest that high a prevalence of various toxin genes together with enhanced resistance to cathelicidins may contribute to the pathogenicity of S. pseudintermedius and S. schleiferi in canine cutaneous infections.
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Affiliation(s)
- Gi Yong Lee
- Department of Veterinary Microbiology, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea
| | - Soo In Lee
- School of Bioresources and Bioscience, Chung-Ang University, Anseong 17546, Korea
| | - Ji Heon Park
- Department of Veterinary Microbiology, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea
| | - Sun Do Kim
- School of Bioresources and Bioscience, Chung-Ang University, Anseong 17546, Korea
| | - Geun-Bae Kim
- School of Bioresources and Bioscience, Chung-Ang University, Anseong 17546, Korea
| | - Soo-Jin Yang
- Department of Veterinary Microbiology, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, Korea.
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Loïez A, Wallet F, Vuotto F, Duployez C. Infectious hazards of tatami mats. Ann Biol Clin (Paris) 2023; 81:448-452. [PMID: 37864447 DOI: 10.1684/abc.2023.1832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
A 16-year old girl consulted for repeated axillary abscesses. The bacteriological culture yielded monomicrobial Staphylococcus aureus. Faced with these recurrent abscesses in an immunocompetent patient playing a close contact sport, the biologist suspected the strain to harbor a virulence factor explaining these recurrences.
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Affiliation(s)
| | | | - Fanny Vuotto
- Service des Maladies Infectieuses, CHU de Lille, Lille, France
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Nguyen NTQ, Doan TNM, Sato K, Tkaczyk C, Sellman BR, Diep BA. Monoclonal antibodies neutralizing alpha-hemolysin, bicomponent leukocidins, and clumping factor A protected against Staphylococcus aureus-induced acute circulatory failure in a mechanically ventilated rabbit model of hyperdynamic septic shock. Front Immunol 2023; 14:1260627. [PMID: 37781371 PMCID: PMC10541218 DOI: 10.3389/fimmu.2023.1260627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/22/2023] [Indexed: 10/03/2023] Open
Abstract
Background Patients with septic shock caused by Staphylococcus aureus have mortality rates exceeding 50%, despite appropriate antibiotic therapy. Our objectives were to establish a rabbit model of S. aureus septic shock and to determine whether a novel immunotherapy can prevent or halt its natural disease progression. Methods Anesthetized rabbits were ventilated with lung-protective low-tidal volume, instrumented for advanced hemodynamic monitoring, and characterized for longitudinal changes in acute myocardial dysfunction by echocardiography and sepsis-associated biomarkers after S. aureus intravenous challenge. To demonstrate the potential utility of this hyperdynamic septic shock model for preclinical drug development, rabbits were randomized for prophylaxis with anti-Hla/Luk/ClfA monoclonal antibody combination that neutralizes alpha-hemolysin (Hla), the bicomponent pore-forming leukocidins (Luk) including Panton-Valentine leukocidin, leukocidin ED, and gamma-hemolysin, and clumping factor A (ClfA), or an irrelevant isotype-matched control IgG (c-IgG), and then challenged with S. aureus. Results Rabbits challenged with S. aureus, but not those with saline, developed a hyperdynamic state of septic shock characterized by elevated cardiac output (CO), increased stroke volume (SV) and reduced systemic vascular resistance (SVR), which was followed by a lethal hypodynamic state characterized by rapid decline in mean arterial pressure (MAP), increased central venous pressure, reduced CO, reduced SV, elevated SVR, and reduced left-ventricular ejection fraction, thereby reproducing the hallmark clinical features of human staphylococcal septic shock. In this model, rabbits pretreated with anti-Hla/Luk/ClfA mAb combination had 69% reduction in mortality when compared to those pretreated with c-IgG (P<0.001). USA300-induced acute circulatory failure-defined as >70% decreased in MAP from pre-infection baseline-occurred in only 20% (2/10) of rabbits pretreated with anti-Hla/Luk/ClfA mAb combination compared to 100% (9/9) of those pretreated with c-IgG. Prophylaxis with anti-Hla/Luk/ClfA mAb combination halted progression to lethal hypodynamic shock, as evidenced by significant protection against the development of hyperlactatemia, hypocapnia, hyperkalemia, leukopenia, neutropenia, monocytopenia, lymphopenia, as well as biomarkers associated with acute myocardial injury. Conclusion These results demonstrate the potential utility of a mechanically ventilated rabbit model that reproduced hallmark clinical features of hyperdynamic septic shock and the translational potential of immunotherapy targeting S. aureus virulence factors for the prevention of staphylococcal septic shock.
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Affiliation(s)
- Nhu T. Q. Nguyen
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Thien N. M. Doan
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Kei Sato
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Christine Tkaczyk
- Early Vaccines and Immune Therapies, AstraZeneca, Gaithersburg, MD, United States
| | - Bret R. Sellman
- Early Vaccines and Immune Therapies, AstraZeneca, Gaithersburg, MD, United States
| | - Binh An Diep
- Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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10
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He J, Yang X, Yang K, Xu H, Chen C, Wang J, Zeng J. TPST2-mediated receptor tyrosine sulfation enhances leukocidin cytotoxicity and S. aureus infection. Front Immunol 2023; 14:1242330. [PMID: 37671153 PMCID: PMC10476081 DOI: 10.3389/fimmu.2023.1242330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/31/2023] [Indexed: 09/07/2023] Open
Abstract
Background An essential fact underlying the severity of Staphylococcus aureus (S. aureus) infection is the bicomponent leukocidins released by the pathogen to target and lyse host phagocytes through specific binding cell membrane receptors. However, little is known about the impact of post-transcriptional modification of receptors on the leukocidin binding. Method In this study, we used small interfering RNA library (Horizon/Dharmacon) to screen potential genes that affect leukocidin binding on receptors. The cell permeability was investigated through flow cytometry measuring the internalization of 4',6-diamidino-2-phenylindole. Expression of C5a anaphylatoxin chemotactic receptor 1 (C5aR1), sulfated C5aR1 in, and binding of 6x-His-tagged Hemolysin C (HlgC) and Panton-Valentine leukocidin (PVL) slow-component to THP-1 cell lines was detected and analyzed via flow cytometry. Bacterial burden and Survival analysis experiment was conducted in WT and myeloid TPST-cko C57BL/6N mice. Results After short hairpin RNA (shRNA) knockdown of TPST2 gene in THP-1, HL-60, and RAW264.7, the cytotoxicity of HlgAB, HlgCB, and Panton-Valentine leukocidin on THP-1 or HL-60 cells was decreased significantly, and the cytotoxicity of HlgAB on RAW264.7 cells was also decreased significantly. Knockdown of TPST2 did not affect the C5aR1 expression but downregulated cell surface C5aR1 tyrosine sulfation on THP-1. In addition, we found that the binding of HlgC and LukS-PV on cell surface receptor C5aR1 was impaired in C5aR1+TPST2- and C5aR1-TPST2- cells. Phagocyte knockout of TPST2 protects mice from S. aureus infection and improves the survival of mice infected with S. aureus. Conclusion These results indicate that phagocyte TPST2 mediates the bicomponent leukocidin cytotoxicity by promoting cell membrane receptor sulfation modification that facilitates its binding to leukocidin S component.
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Affiliation(s)
- Jie He
- Division of Pulmonary and Critical Care Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Xianggui Yang
- Department of Laboratory Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Kai Yang
- Division of Pulmonary and Critical Care Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | | | | | | | - Jun Zeng
- Division of Pulmonary and Critical Care Medicine, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
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11
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Lee CY, Chen CJ. Bacteremic necrotizing mediastinitis caused by community-associated clonal complex 398 methicillin-resistant Staphylococcus aureus in a baby aged 4 months. Int J Infect Dis 2023; 129:15-18. [PMID: 36657517 DOI: 10.1016/j.ijid.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023] Open
Abstract
Invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) diseases caused by clonal complex 398 MRSA without animal contact have become a new emerging threat. We report a case of bacteremic mediastinitis caused by a Panton-Valentine leukocidin-positive community-associated sequence type 1232 MRSA in a Taiwanese baby aged 4 months without animal contact.
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Affiliation(s)
- Chun Yi Lee
- Department of Pediatrics, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
| | - Chih Jung Chen
- Division of Pediatric Infectious Diseases, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan
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12
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Zeouk I, Ouedrhiri W, Sifaoui I, Bazzocchi IL, Piñero JE, Jiménez IA, Lorenzo-Morales J, Bekhti K. Bioguided Isolation of Active Compounds from Rhamnus alaternus against Methicillin-Resistant Staphylococcus aureus (MRSA) and Panton-Valentine Leucocidin Positive Strains (MSSA-PVL). Molecules 2021; 26:molecules26144352. [PMID: 34299627 PMCID: PMC8306708 DOI: 10.3390/molecules26144352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/24/2023] Open
Abstract
Despite intensified efforts to develop an effective antibiotic, S. aureus is still a major cause of mortality and morbidity worldwide. The multidrug resistance of bacteria has considerably increased the difficulties of scientific research and the concomitant emergence of resistance is to be expected. In this study we have investigated the in vitro activity of 15 ethanol extracts prepared from Moroccan medicinal plants traditionally used for treatment of skin infections. Among the tested species I. viscosa, C. oxyacantha, R. tinctorum, A. herba alba, and B. hispanica showed moderate anti-staphylococcal activity. However, R. alaternus showed promising growth-inhibitory effects against specific pathogenic bacteria especially methicillin-susceptible Staphylococcus aureus Panton-Valentine leucocidin positive (MSSA-PVL) and methicillin-resistant S. aureus (MRSA). The bioguided fractionation of this plant using successive chromatographic separations followed by nuclear magnetic resonance (NMR) and mass spectrometry (MS) including EIMS and HREIMS analysis yielded the emodin (1) and kaempferol (2). Emodin being the most active with MICs ranging between 15.62 and 1.95 µg/mL and showing higher activity against the tested strains in comparison with the crude extract, its mechanism of action and the structure-activity relationship were interestingly discussed. The active compound has not displayed toxicity toward murine macrophage cells. The results obtained in the current study support the traditional uses of R. alaternus and suggest that this species could be a good source for the development of new anti-staphylococcal agents.
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Affiliation(s)
- Ikrame Zeouk
- Instituto Universitario De Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203 La Laguna, Spain;
- Laboratory of Microbial Biotechnology and Bioactive Molecules, Department of Biology, Faculty of Sciences and Techniques, Sidi Mohamed Ben Abdellah University, Fez 2202, Morocco;
- Correspondence: (I.Z.); (J.E.P.); (J.L.-M.); Tel.: +212-621-290-377 (I.Z.); +349-22-316-502 (J.E.P.); +349-22-318-402 (J.L.-M.)
| | - Wessal Ouedrhiri
- Laboratory of Engineering, Electrochemistry, Modeling and Environment, Department of Chemistry, Faculty of Science, Sidi Mohamed Ben Abdellah University, Fez 2202, Morocco;
| | - Ines Sifaoui
- Instituto Universitario De Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203 La Laguna, Spain;
- Departamento de Obstetricia, Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de la Laguna, 38203 La Laguna, Spain
- Red de Investigación Colaborativa en Enfermedades Tropicales (RICET), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Isabel L. Bazzocchi
- Departamento de Química Orgánica, Instituto Universitario de Bio-Orgánica Antonio González, Universidad de La Laguna, Avenida Astrofísico Francisco Sánchez 2, 38206 La Laguna, Spain; (I.L.B.); (I.A.J.)
| | - José E. Piñero
- Instituto Universitario De Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203 La Laguna, Spain;
- Departamento de Obstetricia, Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de la Laguna, 38203 La Laguna, Spain
- Red de Investigación Colaborativa en Enfermedades Tropicales (RICET), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (I.Z.); (J.E.P.); (J.L.-M.); Tel.: +212-621-290-377 (I.Z.); +349-22-316-502 (J.E.P.); +349-22-318-402 (J.L.-M.)
| | - Ignacio A. Jiménez
- Departamento de Química Orgánica, Instituto Universitario de Bio-Orgánica Antonio González, Universidad de La Laguna, Avenida Astrofísico Francisco Sánchez 2, 38206 La Laguna, Spain; (I.L.B.); (I.A.J.)
| | - Jacob Lorenzo-Morales
- Instituto Universitario De Enfermedades Tropicales y Salud Pública de Canarias, Universidad de la Laguna, Avda. Astrofísico Fco. Sánchez, S/N, 38203 La Laguna, Spain;
- Departamento de Obstetricia, Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de la Laguna, 38203 La Laguna, Spain
- Red de Investigación Colaborativa en Enfermedades Tropicales (RICET), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: (I.Z.); (J.E.P.); (J.L.-M.); Tel.: +212-621-290-377 (I.Z.); +349-22-316-502 (J.E.P.); +349-22-318-402 (J.L.-M.)
| | - Khadija Bekhti
- Laboratory of Microbial Biotechnology and Bioactive Molecules, Department of Biology, Faculty of Sciences and Techniques, Sidi Mohamed Ben Abdellah University, Fez 2202, Morocco;
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13
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Budzyńska A, Skowron K, Kaczmarek A, Wietlicka-Piszcz M, Gospodarek-Komkowska E. Virulence Factor Genes and Antimicrobial Susceptibility of Staphylococcus aureus Strains Isolated from Blood and Chronic Wounds. Toxins (Basel) 2021; 13:toxins13070491. [PMID: 34357963 PMCID: PMC8310355 DOI: 10.3390/toxins13070491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/12/2021] [Indexed: 12/24/2022] Open
Abstract
Staphylococcus aureus is one of the predominant bacteria isolated from skin and soft tissue infections and a common cause of bloodstream infections. The aim of this study was to compare the rate of resistance to various antimicrobial agents and virulence patterns in a total of 200 S. aureus strains isolated from patients with bacteremia and chronic wounds. Disk diffusion assay and in the case of vancomycin and teicoplanin-microdilution assay, were performed to study the antimicrobial susceptibility of the isolates. The prevalence of genes encoding six enterotoxins, two exfoliative toxins, the Panton–Valentine leukocidin and the toxic shock syndrome toxin was determined by PCR. Of the 100 blood strains tested, the highest percentage (85.0%, 31.0%, and 29.0%) were resistant to benzylpenicillin, erythromycin and clindamycin, respectively. Out of the 100 chronic wound strains, the highest percentage (86.0%, 32.0%, 31.0%, 31.0%, 30.0%, and 29.0%) were confirmed as resistant to benzylpenicillin, tobramycin, amikacin, norfloxacin, erythromycin, and clindamycin, respectively. A significantly higher prevalence of resistance to amikacin, gentamicin, and tobramycin was noted in strains obtained from chronic wounds. Moreover, a significant difference in the distribution of sea and sei genes was found. These genes were detected in 6.0%, 46.0% of blood strains and in 19.0%, and 61.0% of wound strains, respectively. Our results suggest that S. aureus strains obtained from chronic wounds seem to be more often resistant to antibiotics and harbor more virulence genes compared to strains isolated from blood.
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Affiliation(s)
- Anna Budzyńska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 M. Skłodowska-Curie St., 85-094 Bydgoszcz, Poland; (A.B.); (A.K.); (E.G.-K.)
| | - Krzysztof Skowron
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 M. Skłodowska-Curie St., 85-094 Bydgoszcz, Poland; (A.B.); (A.K.); (E.G.-K.)
- Correspondence: ; Tel.: +48-512-210-245
| | - Agnieszka Kaczmarek
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 M. Skłodowska-Curie St., 85-094 Bydgoszcz, Poland; (A.B.); (A.K.); (E.G.-K.)
| | - Magdalena Wietlicka-Piszcz
- Department of Theoretical Foundations of Biomedical Sciences and Medical Computer Science, L. Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 M. Skłodowska-Curie St., 85-094 Bydgoszcz, Poland;
| | - Eugenia Gospodarek-Komkowska
- Department of Microbiology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 M. Skłodowska-Curie St., 85-094 Bydgoszcz, Poland; (A.B.); (A.K.); (E.G.-K.)
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14
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Nieto-Benito LM, Ruedas-Martínez A, Suárez-Fernández RM, Pulido-Pérez A. Painful furuncles and abscesses in the genital area associated with functional impairment. Enferm Infecc Microbiol Clin (Engl Ed) 2021; 39:300-301. [PMID: 34088452 DOI: 10.1016/j.eimce.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/20/2020] [Indexed: 06/12/2023]
Affiliation(s)
| | | | | | - Ana Pulido-Pérez
- Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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15
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Capasso L, Cerullo J, Lo Vecchio A, Coppola C, Lepore L, Marra V, Antonaki E, Raimondi F. An unusual aggressive presentation of late onset sepsis due to Staphylococcus aureus MRSA producing Panton-Valentine Leukocidin in preterm neonate. Acta Biomed 2021; 92:e2021147. [PMID: 33944831 PMCID: PMC8142768 DOI: 10.23750/abm.v92is1.9885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
We report an unusual and rare case of infection from methicillin resistant Staphylococcus aureus (MRSA) producing Panton-Valentine leukocidin in a preterm neonate in NICU. On day of life 8, a preterm baby boy suddenly developed arthritis, giant cutaneous abscesses and an osteomyelitic focus with pour clinical condition. This very aggressive presentation of infection from MRSA push us to test Panton-Valentine leukocidin resulted positive and to test contacts to discover the bearer of the germ. MRSA producing Panton-Valentine leukocidin is an unusual case of infection in preterm neonate that has not been reported elsewhere. A very aggressive sepsis in neonates from Staphilococcus aureus should evoke the need to test Panton-Valentine leukocidin to rapidly establish an appropriate treatment. We underline also the importance to test contacts to establish promptly a decontaminant therapy.
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Affiliation(s)
- Letizia Capasso
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Napoli, Italy..
| | - Julia Cerullo
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Napoli, Italy.
| | - Andrea Lo Vecchio
- Pediatric Infectious Diseases Unit. Departement of Translational Medical Science. University Federico II, Napoli, Italy..
| | - Clara Coppola
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Napoli, Italy.
| | - Lorenza Lepore
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Napoli. Italy.
| | - Valentina Marra
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Via Pansini 5, 80131. Napoli. Italy.
| | - Eleni Antonaki
- Department of Molecular Medicine and Medical Biotechnology - Division of Bacteriology and Mycology, University of Naples. Federico II, Naples, Italy.
| | - Francesco Raimondi
- Neonatology, Pediatrics. Departement of Translational Medical Science. University Federico II, Napoli. Italy.
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16
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Galant J, Corcostegui SP, Ramon F, Commeau D, Penserini V, Loreau JM, de Laval F, Boutillier du Retail C. [Managing an epidemic of Panton-Valentine Leucocidin-secreting Staphylococcusaureus in a hostile environment]. Ann Dermatol Venereol 2020; 147:665-666. [PMID: 32653220 DOI: 10.1016/j.annder.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/02/2020] [Indexed: 11/19/2022]
Affiliation(s)
- J Galant
- 1(re) antenne médicale spécialisée, 34, rue de la Martinière, 78000 Versailles, France.
| | - S-P Corcostegui
- 1(re) antenne médicale spécialisée, 34, rue de la Martinière, 78000 Versailles, France
| | - F Ramon
- 1(re) antenne médicale spécialisée, 34, rue de la Martinière, 78000 Versailles, France
| | - D Commeau
- 1(re) antenne médicale spécialisée, 34, rue de la Martinière, 78000 Versailles, France
| | - V Penserini
- École du Val de Grâce, 1, place Laveran, 75230 Paris, France
| | - J-M Loreau
- Unité de surveillance épidémiologique et investigation, Centre d'épidémiologie et de santé publique des armées, camp militaire de Sainte-Marthe, 408, rue Jean-Queillau, 13014 Marseille, France
| | - F de Laval
- Unité de surveillance épidémiologique et investigation, Centre d'épidémiologie et de santé publique des armées, camp militaire de Sainte-Marthe, 408, rue Jean-Queillau, 13014 Marseille, France
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17
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Cori MS, Ronconi G, Masiello E, Valentini P, Ferriero G, Maccauro G, Ferrara PE. Staphylococcus Aureus Panton-Valentine Leukocidin causing hip osteomyelitis, thrombophlebitis and necrotizing pneumonia in an immuocompetent child. J BIOL REG HOMEOS AG 2020; 34:53-56. ADVANCES IN MUSCULOSKELETAL DISEASES AND INFECTIONS-SOTIMI 2019. [PMID: 32856440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Panton-Valentine leukocidin (PVL) represents an important virulence factor for many strains of Staphylococcus aureus. PVL is an esotoxin causing leucocyte destruction and tissue necrosis. We report on a case of osteomyelitis involving the hip joint with thromblophlebitis complicated by necrotizing pneumonia and life-threatening septic shock. The child required advance respiratory support for 14 days with circulatory support for 7 days in ICU (intensive care unit), surgical draninage via arthrotomy of hip joint and second-line antibiotic treatment for 1 month. Among a wide literature, in Europe over half of Panton-Valentine St. Aureus (PVL-SA) is MSSA. Investigations for PVL are not always available determining an under-recognition of the episodes. Data on prevalence of PVL-SA in Italy are scarce. With this clinical report, we emphasize the recognition of clinical features that must lead to suspect PVL-SA osteomyelitis in children, providing their adequate management.
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Affiliation(s)
- M S Cori
- Pediatric Institute Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome Italy
| | - G Ronconi
- UO Degenza e Servizi di Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome Italy
| | - E Masiello
- Pediatric Institute Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome Italy
| | - P Valentini
- Pediatric Institute Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome Italy
| | - G Ferriero
- Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - G Maccauro
- Orthopedic and Traumatology Institute, Catholic University of the Sacred Heart, Rome, Italy
| | - P E Ferrara
- UO Degenza e Servizi di Riabilitazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome Italy
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18
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Wang Y, Lin J, Zhang T, He S, Li Y, Zhang W, Ye X, Yao Z. Environmental Contamination Prevalence, Antimicrobial Resistance and Molecular Characteristics of Methicillin-Resistant Staphylococcus Aureus and Staphylococcus Epidermidis Isolated from Secondary Schools in Guangzhou, China. Int J Environ Res Public Health 2020; 17:ijerph17020623. [PMID: 31963695 PMCID: PMC7013935 DOI: 10.3390/ijerph17020623] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/13/2020] [Accepted: 01/15/2020] [Indexed: 12/19/2022]
Abstract
Background: Methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE), the most prevalent causes of hospital-associated and community-associated infections, could exist on frequently touched surfaces. This study aims to determine the contamination prevalence and the characteristics of MRSA and MRSE isolated from secondary school environments. Methods: We collected environmental samples from ten secondary schools in Guangzhou city between October 2016 and January 2017. The samples were confirmed for MRSA and MRSE isolates by using biochemical tests and polymerase chain reactions. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method. Staphylococcal cassette chromosome mec (SCCmec) typing, toxin gene screening, and multilocus sequence typing (MLST) were performed to further characterize the isolates. Data were analyzed by two-sample proportion tests. Results: A total of 1830 environmental samples were collected. The prevalence of MRSA and MRSE contamination were 1.86% (34/1830) and 5.14% (94/1830), respectively. The proportions of multidrug resistance in both MRSA (58.82%) and MRSE (63.83%) isolates were high. Seven clonal complexes (CC) and 12 sequence types (ST) were identified, with the CC5 (35.29%) and ST45 (25.53%) being the most prevalent. We found that 44.12% of the MRSA isolates were community-acquired and the main type was ST45-SCCmec IV. We found that 5.88% and 32.35% of MRSA isolates were positive to Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin-1 (tst) gene, respectively. No MRSE isolate was positive to the toxin genes. Conclusion: Our findings raise potential public health concerns for environmental contamination of MRSA and MRSE in school environments. Surfaces of school environments may potentially provide a source for cross-contamination with these bacteria into the wider community.
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Affiliation(s)
- Yingying Wang
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
| | - Jialing Lin
- School of Public Health and Community Medicine, The University of New South Wales, Sydney 2052, Australia;
| | - Ting Zhang
- Department of immunization programme, Dongguan Center for Disease Control and Prevention, Dongguan 523000, China;
| | - Suiping He
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
| | - Ying Li
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
| | - Wencui Zhang
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
| | - Xiaohua Ye
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
- Correspondence: (X.Y.); (Z.Y.)
| | - Zhenjiang Yao
- Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou 510310, China; (Y.W.); (S.H.); (Y.L.); (W.Z.)
- Correspondence: (X.Y.); (Z.Y.)
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19
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Pérez S, Liaudet A, Favrat B, Cornuz J, Greub G. [Staphylococcus aureus producing Panton-Valentine leukocidin : notions in clinical practice]. Rev Med Suisse 2018; 14:1946-1950. [PMID: 30379477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Staphylococcal skin infections, especially recurrent abscesses, or those that do not respond to conventional treatment (drainage or antibiotics), are frequently associated with the Panton-Valentine leucocidin (PVL) toxin which may be diagnosed by PCR in the laboratory with a result within 24 hours. Treatment changes according to the clinical presentation and the resistance of Staphylococcus.The presence of these PVL-producing strains is increasingly frequent in clinical practice, partially because of the current migratory flow. We will need epidemiological studies to determine the exact prevalence in Europe.
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Affiliation(s)
- Sara Pérez
- Policlinique médicale universitaire, 1011 Lausanne
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20
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Abstract
The recent spread of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) has brought increasing concerns of heightened disease severity and persistence following invasive disease. In line with the need for new treatment paradigms, two recent reports have shown that antibody-based therapies can restrict acute S. aureus infection and persistence and improve pathological symptoms.
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Affiliation(s)
- Bo Shopsin
- Department of Microbiology, New York University School of Medicine, New York, NY 10016, USA; Division of Infectious Diseases, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Srini V Kaveri
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris 75006, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1138, Paris 75006, France; Université Paris Descartes, Sorbonne Paris Cité, UMR S 1138, Paris 75006, France; Centre de Recherche des Cordeliers, Equipe - Immunopathologie et immuno-intervention thérapeutique, Paris 75006, France
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale Unité 1138, Paris 75006, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 1138, Paris 75006, France; Université Paris Descartes, Sorbonne Paris Cité, UMR S 1138, Paris 75006, France; Centre de Recherche des Cordeliers, Equipe - Immunopathologie et immuno-intervention thérapeutique, Paris 75006, France.
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Prince A, Wang H, Kitur K, Parker D. Humanized Mice Exhibit Increased Susceptibility to Staphylococcus aureus Pneumonia. J Infect Dis 2017; 215:1386-1395. [PMID: 27638942 DOI: 10.1093/infdis/jiw425] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/11/2016] [Indexed: 12/23/2022] Open
Abstract
Staphylococcus aureus is a highly successful human pathogen that has evolved in response to human immune pressure. The common USA300 methicillin-resistant S. aureus (MRSA) strains express a number of toxins, such as Panton-Valentine leukocidin and LukAB, that have specificity for human receptors. Using nonobese diabetic (NOD)-scid IL2Rγnull (NSG) mice reconstituted with a human hematopoietic system, we were able to discriminate the roles of these toxins in the pathogenesis of pneumonia. We demonstrate that expression of human immune cells confers increased severity of USA300 infection. The expression of PVL but not LukAB resulted in more-severe pulmonary infection by the wild-type strain (with a 30-fold increase in the number of colony-forming units/mL; P < .01) as compared to infection with the lukS/F-PV (Δpvl) mutant. Treatment of mice with anti-PVL antibody also enhanced bacterial clearance. We found significantly greater numbers (by 95%; P < .05) of macrophages in the airways of mice infected with the Δpvl mutant compared with those infected with the wild-type strain, as well as significantly greater expression of human tumor necrosis factor and interleukin 6 (84% and 51% respectively; P < .01). These results suggest that the development of humanized mice may provide a framework to assess the contribution of human-specific toxins and better explore the roles of specific components of the human immune system in protection from S. aureus infection.
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Affiliation(s)
- Alice Prince
- Department Pediatrics
- Department of Pharmacology, and
| | - Hui Wang
- Humanized Mouse Core Facility, Columbia Center for Translational Immunology, Columbia University, New York
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22
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Raab U, Kahlau D, Wagenlehner F, Reischl U, Ehrenstein V, Lehn N, Holler C, Linde HJ. Prevalence of and Risk Factors for Carriage of Panton-Valentine Leukocidin–Positive Methicillin-ResistantStaphylococcus aureusAmong Residents and Staff of a German Nursing Home. Infect Control Hosp Epidemiol 2016; 27:208-11. [PMID: 16465643 DOI: 10.1086/500629] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 10/12/2005] [Indexed: 11/03/2022]
Abstract
The aims of this cross-sectional study were to determine the prevalence of and risk factors for carriage of Panton-Valentine leukocidin–producing methicillin-resistantStaphylococcus aureus(PVL-MRSA) in residents and personnel of a nursing home in Germany. In this study, PVL-MRSA carriage status among nursing home residents was associated with risk factors reflecting their dependence on nursing care. No specific risk factors were detected among staff.
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Affiliation(s)
- Ulla Raab
- Institut für Medizinische Mikrobiologie, Universität Regensburg, Landshuterstr. 22, 93047 Regensburg, Germany.
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23
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Jaton L, Kritikos A, Bodenmann P, Greub G, Merz L. [European migrant crisis and reemergence of infections in Switzerland]. Rev Med Suisse 2016; 12:749-753. [PMID: 27263151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Current conflicts in some regions of the world give rise to massive immigration waves. Consequently, some infections that had nearly disappeared in Europe nowadays re-emerge. They are related to the epidemiology of the refugees' origin, but also to the epidemiology of the country crossed during migration. Hygiene conditions, often precarious during the journey, favor their transmission. Thus, cases of louse borne relapsing fever and diphtheria emerge in Europe and in Switzerland since 2074 whereas cutaneous Panton-Valen tine Staphylococcus aureus infection are more commonly observed nowadays.
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24
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Vayalumkal JV, Whittingham H, Vanderkooi O, Stewart TE, Low DE, Mulvey M, McGeer A. Necrotizing pneumonia and septic shock: suspecting CA-MRSA in patients presenting to Canadian emergency departments. CAN J EMERG MED 2015; 9:300-3. [PMID: 17626697 DOI: 10.1017/s1481803500015219] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTWe report a case of fatal necrotizing pneumonia and sepsis caused by community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) in an otherwise well, 48-year-old Canadian man with type 2 diabetes mellitus who had travelled to Texas. Despite therapy that included intravenous antibiotics, intravenous immune globulin and other supportive measures, the patient succumbed to his illness. Recently, CA-MRSA pneumonia has been reported in several countries. The virulence of this organism may in part be related to its ability to produce toxins, such as Panton-Valentine leukocidin. As rates of CA-MRSA increase worldwide, physicians should be aware of the potential for MRSA to cause life-threatening infections in patients presenting to Canadian emergency departments (EDs). Necrotizing pneumonia caused by MRSA must be considered in the differential diagnosis of acute, severe respiratory illness. Early recognition of this syndrome in the ED may help physicians initiate appropriate antibiotic therapy in a timely manner.
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Affiliation(s)
- Joseph V Vayalumkal
- Department of Pediatrics, Division of Infectious Diseases, Alberta Children's Hospital, University of Calgary, Calgary, Alberta
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25
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Shrestha B. Review on Panton Valentine leukocidin toxin carriage among Staphylococcus aureus. J Nepal Health Res Counc 2013; 11:305-312. [PMID: 24908537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Panton Valentine leukocidin is a toxin making pores in the polymorphonuclear cells which is a virulence factor of some strains of Staphylococcus aureus. Initially it was produced by methicillin susceptible Staphylococcus aureus only. Later with the acquisition of mecA gene has lead it to be PVL positive methicillin resistant Staphylococcus aureus. Since MRSA are resistant to many antibiotics and further they produce a toxin the infections by PVL positive MRSA has become a challenge. PVL positive MRSA a virulent strain of drug resistant superbug MRSA that has spread around the world, has claimed many lives in UK, Europe, USA and Australia. Some strains of superbug attack the healthy young people and kill within 24 hrs. PVL positive Staphylococcus aureus has been reported to be associated with skin and soft tissue infections however they also cause invasive infections and necrotizing pneumonia. These microorganisms known to be community associated have spread to hospitals. Hospital acquired infection by such microorganisms lead to an increase in mortality hence should be controlled before they become prevalent in hospitals.
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Affiliation(s)
- B Shrestha
- Department of Microbiology, Tri-Chandra Campus, Tribhuvan University, Nepal
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26
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Cavanagh J, Quinn M, Wong V. Challenge of responding to PVL positive Staphylococcus aureus skin infection. BMJ 2011; 343:d6477. [PMID: 21994298 DOI: 10.1136/bmj.d6477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Robertson K. Don't forget pets in PVL positive Staphylococcus aureus infection. BMJ 2011; 343:d6338. [PMID: 21994297 DOI: 10.1136/bmj.d6338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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28
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Affiliation(s)
- A Fogo
- Dermatology Department, King's College Hospital, London SE5 9RS, UK.
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29
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Shallcross LJ, Mbeledogu CN, Hayward AC. Should we screen and decolonise contacts of patients with Panton Valentine leukocidin associated Staphylococcus aureus infection? BMJ 2011; 343:d5479. [PMID: 21908526 DOI: 10.1136/bmj.d5479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- L J Shallcross
- Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK.
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30
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Adjetey A, Edwards R. Necrotising pneumonia and pandemic influenza. N Z Med J 2010; 123:128-133. [PMID: 21358792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A case of PVL-positive Staphylococcus aureus pneumonia in a 32-year-old female is described. This is one of the first reports of this particular organism causing pneumonia in New Zealand, although the organism has been identified before. With the likelihood of increased numbers of cases of this life-threatening infection in the future in connection with pandemic influenza, an approach to the management of patients with PVL-positive necrotising pneumonia is discussed.
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31
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Affiliation(s)
- Kim Delahanty
- University of California at San Diego Medical Center, CA, USA
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32
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33
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Salliot C, Zeller V, Puechal X, Manceron V, Sire S, Varache N, Etienne J, Desplaces N, Ziza JM. Panton-Valentine leukocidin-producing Staphylococcus aureus infections: Report of 4 French cases. ACTA ACUST UNITED AC 2009; 38:192-5. [PMID: 16507501 DOI: 10.1080/00365540500388776] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report 4 cases of community-acquired infections due to Staphylococcus aureus producing Panton-Valentin leukocidin (SA-PVL) with uncommon multivisceral localizations. These cases highlight the need to screen for PVL in patients with serious staphylococcal infections. All patients were cured. Two of them received intravenous immunoglobulins in addition to antibiotics.
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Affiliation(s)
- Carine Salliot
- Service de Médecine Interne et Rhumatologie et, Groupe Hospitalier Diaconesses--La Croix-Saint Simon, Paris, France.
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34
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Hairon N. Emerging threats: five diseases nurses need to know about. Nurs Times 2008; 104:55-57. [PMID: 19068888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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35
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Vonberg RP, Sedlacek L, Chaberny IF, Suerbaum S, Gastmeier P, Linde HJ. [Multiple abscesses in immunocompetent patients caused by Panton-Valentine leukocidin positive Staphylococcus aureus]. Hautarzt 2008; 59:319-22. [PMID: 17646948 DOI: 10.1007/s00105-007-1374-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report cases of immunocompetent patients showing multiple abscesses by a Panton-Valentine leukocidin (PVL) positive Staphylococcus aureus. PVL is considered to be an important virulence factor. The most common manifestations by this pathogen are recurrent or multiple abscesses of the skin. Seldom necrotizing pneumonia with high mortality occurs. Even methicillin-resistant PVL positive isolates have been identified in Germany. Only appropriate infection control measures in combination with antimicrobial therapy resulted in successful eradication of this pathogen. Dermatologists should be informed about this specific type of infection and about the appropriate infection control measures.
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Affiliation(s)
- R-P Vonberg
- Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover.
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36
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Gillet Y, Dohin B, Dumitrescu O, Lina G, Vandenesch F, Etienne J, Floret D. [Osteoarticular infections with staphylococcus aureus secreting Panton-Valentine leucocidin]. Arch Pediatr 2008; 14 Suppl 2:S102-7. [PMID: 17956817 DOI: 10.1016/s0929-693x(07)80043-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Panton-Valentine Leucocidin (PVL) is associated in the USA with community-acquired meticillin resistant strains of Staphylococcus aureus (CA-MRSA). Bone and joint infection due to such strains appears to be more severe, necessiting longer antibiotic course and various surgical procedure. Our study of 14 PVL positive bone and joint infection, performed in France where PVL is rarely (2/14) associated with meticillin resistance, demonstrates that severity is linked with PVL secretion more than with resistance. Considering PVL associated bone and joint infections as a toxin-mediated disease, prompt diagnosis is needed in order to start specific therapeutic procedures. PVL mediated infection could be evoked in front of severe acute osteomyelitis or arthritis, with radiological abnormalities present in the first days of evolution and with pejorative evolution despite antibiotic treatment. Evolution toward multifocal osteomyelitis and/or multiple abscesses seems to be a major characteristic of such infection. Therapeutic approach should use an association of parenteral antibiotics with at least one molecule active against protein synthesis like Clindamycin, associated with betalactams or Vancomycin in area of high incidence of CA-MRSA. Surgical procedure should be considered whenever focal abscesses of bones or adjacent tissue is detected and should be repeated in most cases.
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Affiliation(s)
- Y Gillet
- Service d'urgences et réanimation pédiatrique, Hôpital Edouard-Herriot, Lyon, France.
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37
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Pouessel G, Ythier H, Carpentier O, Vachée A, Etienne J, Catteau B. Childhood pustular psoriasis associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. Pediatr Dermatol 2007; 24:401-4. [PMID: 17845166 DOI: 10.1111/j.1525-1470.2007.00459.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We report the association of a generalized pustular psoriasis and infection by Staphylococcus aureus which produced Panton-Valentine leukocidin in a 5-year-old child. Another S. aureus strain with the same toxin gene content was also isolated among three family members presenting with cutaneous lesions. Although a methicillin-resistant staphylococcal strain has been reported in association with pustular psoriasis, this is the first report of a Panton-Valentine leukocidin strain associated with generalized pustular psoriasis. The causal relationship between S. aureus produced Panton-Valentine leukocidin and skin lesions is discussed.
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Abstract
Ten methicillin-resistant Staphylococcus aureus (MRSA) isolates from healthy owners and their pets were characterised by susceptibility testing, staphylococcal chromosome cassette (SCC)mec and agr typing, and detection of the Panton-Valentine leukocidin (PVL) genes. Two human and three dog isolates harbouring SCCmec type III appeared to be of hospital origin. The five remaining isolates carried SCCmec type IV, with three being multidrug-resistant. One type IV isolate was PVL-positive and a prototypic agr type 3, typified by strain MW2. This is the first report of this type in association with nasal carriage. Drug resistance may be increasing among community isolates of MRSA.
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Affiliation(s)
- M V Boost
- Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong.
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39
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Iwata K. [CA-MRSA]. Nihon Rinsho 2007; 65 Suppl 2 Pt. 1:436-40. [PMID: 17455658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Kentaro Iwata
- Department of General Medicine and Infectious Diseases, Kameda Medical Center
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40
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Kenny C. PVL-positive MRSA threatens nurses. Nurs Times 2007; 103:8-9. [PMID: 17278725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
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41
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Abstract
Highly virulent community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) with Panton-Valentine leukocidin (PVL) is common worldwide. Using antimicrobial drug susceptibility testing, staphylococcal cassette chromosome mec typing, exotoxin profiling, and pulsed-field gel electrophoresis typing, we provide evidence that supports the relationship between nasal strains of PVL-positive MRSA and community-acquired disease.
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Affiliation(s)
- Wen-Tsung Lo
- National Defense Medical Center, Taipei, Taiwan, Republic of China
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Wei-Jen Lin
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Min-Hua Tseng
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Sheng-Ru Wang
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Mong-Ling Chu
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
| | - Chih-Chien Wang
- National Defense Medical Center, Taipei, Taiwan, Republic of China
- Tri-Service General Hospital, Taipei, Taiwan, Republic of China
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42
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Swaminathan A, Massasso D, Gotis-Graham I, Gosbell I. Fulminant methicillin-sensitive Staphylococcus aureus infection in a healthy adolescent, highlighting 'Panton-Valentine leucocidin syndrome'. Intern Med J 2006; 36:744-7. [PMID: 17040363 DOI: 10.1111/j.1445-5994.2006.01220.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 14-year-old immunocompetent adolescent presented systemically unwell with left knee septic arthritis. Within several days, disseminated bone and soft tissue collections became evident, associated with deep venous thrombosis and pulmonary involvement. Methicillin-sensitive Staphylococcus aureus was isolated, harbouring Panton-Valentine leucocidin genes. Aggressive antibiotic and surgical therapies eventually lead to recovery. Intrafamilial spread of the pathogenic isolate was shown by household screening. This presentation is consistent with 'PVL Syndrome' and is typical of severe S. aureus infection emerging in young populations globally.
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Affiliation(s)
- A Swaminathan
- Clinical Infectious Diseases, Complex Care and General Practice, Liverpool Hospital, Liverpool, NSW, Australia.
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43
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Melles DC, van Leeuwen WB, Boelens HAM, Peeters JK, Verbrugh HA, van Belkum A. Panton-Valentine leukocidin genes in Staphylococcus aureus. Emerg Infect Dis 2006; 12:1174-5. [PMID: 16848048 PMCID: PMC3375734 DOI: 10.3201/eid1207.050865] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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44
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Moumile K, Cadilhac C, Lina G, Berche P, Glorion C, Ferroni A. Severe osteoarticular infection associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. Diagn Microbiol Infect Dis 2006; 56:95-7. [PMID: 16678376 DOI: 10.1016/j.diagmicrobio.2006.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2005] [Revised: 03/02/2006] [Accepted: 03/12/2006] [Indexed: 11/18/2022]
Abstract
We report here a case of osteoarticular infection associated with Panton-Valentine leukocidin-producing Staphylococcus aureus. The 3-year-old child presented osteoarthritis associated with toxic shock syndrome, which was complicated by thrombosis, pneumonia, and diaphysitis, despite appropriate antibiotic treatment. Osteitis associated with toxinogenic S. aureus is rarely described. This case highlights the need of early and aggressive surgical treatment, in addition to appropriate antimicrobial therapy.
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Affiliation(s)
- Kaoutar Moumile
- Laboratoire de Microbiologie, AP-HP, Hôpital Necker-Enfants Malades, 75015 Paris, France
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45
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Skiest D, Brown K, Hester J, Moore T, Crosby C, Mussa HR, Hoffman-Roberts H, Cooper T. Community-onset methicillin-resistant Staphylococcus aureus in an urban HIV clinic. HIV Med 2006; 7:361-8. [PMID: 16903980 DOI: 10.1111/j.1468-1293.2006.00394.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the proportion of skin/soft tissue infections (SSTIs) and to determine risks for MRSA infection caused by methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected out-patients. METHODS We conducted a prospective study of SSTIs in HIV-infected out-patients. A questionnaire was used to record MRSA risk factors and treatment. In vitro testing for antibiotic susceptibility, inducible clindamycin resistance, panton-valentine leucocidin (PVL) toxin, and the staphylococcal chromosomal cassette mec (SCCmec) type was performed using standardized methods. Treatment outcomes included resolution of primary site of infection, nonresolution of infection and reinfection and were confirmed at clinic visit and/or telephone follow-up. RESULTS Forty-one of 44 patients had an SSTI caused by MRSA. African-Americans comprised 21 of 41 MRSA patients. The median CD4 count of MRSA patients was 411 cells/microL. Four patients required hospitalization and three patients had secondary bacteraemia. Twenty-one of 41 MRSA patients had healthcare-associated (HCA) MRSA risk factors including a history of prior MRSA infection (n=9) and hospitalization within 6 months (n=11). Other prevalent MRSA risk factors included receipt of systemic antibiotics within 6 months (n=21) and previous incarceration (n=19). Twenty-two patients had a significant non-HIV-related comorbid illness. The majority of isolates were susceptible to trimethoprim-sulfamethoxazole, tetracycline, and clindamycin. Inducible clindamycin resistance was detected in 0 of 16 erythromycin-resistant, clindamycin-susceptible MRSA isolates. Twenty-one of 24 isolates tested positive for SCCmec type IV. Twenty-four of 24 isolates tested positive for the PVL gene. Antibiotic treatment was discordant (bacteria nonsusceptible to antibiotic used) in eight MRSA patients. The primary SSTI resolved in 37 of 40 MRSA patients. Recurrence of infection at a site other than the primary site was relatively common (11 patients). CONCLUSIONS We found a high rate of MRSA causing SSTI in community-dwelling patients. The majority of isolates were positive for PVL and SCCmec IV, which is typical of community-associated MRSA isolates causing SSTIs in the general population. Inducible clindamycin resistance was not detected. Most patients had MRSA risk factors. The initial site of infection resolved in most cases but subsequent MRSA infection was relatively common.
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Affiliation(s)
- D Skiest
- Division of Infectious Diseases, The University of Texas Southwestern Medical Center, Dallas, USA.
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46
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Nishiyama A, Kaneko J, Harata M, Kamio Y. Assembly of staphylococcal leukocidin into a pore-forming oligomer on detergent-resistant membrane microdomains, lipid rafts, in human polymorphonuclear leukocytes. Biosci Biotechnol Biochem 2006; 70:1300-7. [PMID: 16794307 DOI: 10.1271/bbb.50499] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Staphylococcal leukocidin (Luk) consists of LukS and LukF, which cooperatively lyse human polymorphonuclear leukocytes (HPMNLs), monocytes, and macrophages. Here we found that LukS and LukF assembles into hetero-oligomeric pore complexes on the detergent-resistant membrane microdomains, lipid rafts of HPMNLs. When HPMNLs were treated with LukS alone, 24% of the added LukS was localized in lipid rafts. Furthermore, in HPMNLs treated with both LukS and LukF simultaneously, about 90% of high molecular-mass complexes of 100 kDa, which consists of LukS and LukF, were detected in the lipid raft fractions. In contrast, in HPMNLs treated with LukF alone, LukF was not localized in lipid rafts despite binding to the target cell membranes. Ten mM methyl-beta-cyclodextrin, a dysfunctioning agent of lipid rafts, completely inhibited assembly of Luk on lipid rafts, and resulted in null leukocytolytic activity of Luk. Hence, we concluded that assembly of LukS and LukF into the pore-complex occurs in lipid rafts in HPMNLs and that LukF can bind to LukS, which had already bound to lipid rafts, to assemble into hetero-oligomers.
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Affiliation(s)
- Akihito Nishiyama
- Laboratory of Applied Microbiology, Department of Microbial Biotechnology, Graduate School of Agricultural Science, Tohoku University
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47
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Müller-Premru M, Strommenger B, Alikadic N, Witte W, Friedrich AW, Seme K, Kucina NS, Smrke D, Spik V, Gubina M. New strains of community-acquired methicillin-resistant Staphylococcus aureus with Panton-Valentine leukocidin causing an outbreak of severe soft tissue infection in a football team. Eur J Clin Microbiol Infect Dis 2006; 24:848-50. [PMID: 16341520 DOI: 10.1007/s10096-005-0048-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M Müller-Premru
- Institute of Microbiology and Immunology, Medical Faculty, Zaloska 4, Ljubljana, Slovenia.
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Monecke S, Slickers P, Hotzel H, Richter-Huhn G, Pohle M, Weber S, Witte W, Ehricht R. Microarray-based characterisation of a Panton-Valentine leukocidin-positive community-acquired strain of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2006; 12:718-28. [PMID: 16842566 DOI: 10.1111/j.1469-0691.2006.01420.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Recent years have witnessed the emergence of novel methicillin-resistant Staphylococcus aureus (MRSA) strains that produce the potent toxin Panton-Valentine leukocidin (PVL). PVL-positive strains can cause complicated skin infections or necrotising pneumonia with high mortality, and these strains have the potential for epidemic spread in the community. In 2004-2005, two case clusters and two isolated cases were observed in eastern Saxony and southern Brandenburg. These were the first known infections with PVL-positive community-acquired MRSA (caMRSA) in this part of Germany. The isolates belonged to agr type III, spa type 44 or spa type 131, and showed a SmaI macrorestriction pattern that corresponded to caMRSA of clonal group ST80. The isolates were susceptible to levofloxacin, macrolides, clindamycin, gentamicin and vancomycin. Most isolates showed resistance to tetracycline and fusidic acid because of the presence of the tetK and far1 genes. A novel plasmid (designated pUB102) harbouring far1, tetK and blaZ was characterised and partially sequenced. Microarray analysis revealed that the caMRSA isolates harboured genes encoding several bi-component toxins (lukF/S-PVL, lukD/E, lukS/F plus hlgA, and another putative leukocidin homologue). Neither tst1 nor genes for enterotoxins A-Y were detected, but the isolates harboured several staphylococcal enterotoxin-like toxin genes (set genes), as well as genes encoding an epidermal cell differentiation inhibitor (edinB) and exfoliative toxin D (etD). Comparative analysis of other isolates from Australia, Germany, Switzerland and the UK showed that these isolates were representative of a widespread clone of caMRSA.
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Affiliation(s)
- S Monecke
- Institute for Medical Microbiology and Hygiene, Faculty of Medicine, Carl Gustav Carus at the Technical University of Dresden, Dresden, Germany.
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Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, Talan DA. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006; 355:666-74. [PMID: 16914702 DOI: 10.1056/nejmoa055356] [Citation(s) in RCA: 1691] [Impact Index Per Article: 93.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly recognized in infections among persons in the community without established risk factors for MRSA. METHODS We enrolled adult patients with acute, purulent skin and soft-tissue infections presenting to 11 university-affiliated emergency departments during the month of August 2004. Cultures were obtained, and clinical information was collected. Available S. aureus isolates were characterized by antimicrobial-susceptibility testing, pulsed-field gel electrophoresis, and detection of toxin genes. On MRSA isolates, we performed typing of the staphylococcal cassette chromosome mec (SCCmec), the genetic element that carries the mecA gene encoding methicillin resistance. RESULTS S. aureus was isolated from 320 of 422 patients with skin and soft-tissue infections (76 percent). The prevalence of MRSA was 59 percent overall and ranged from 15 to 74 percent. Pulsed-field type USA300 isolates accounted for 97 percent of MRSA isolates; 74 percent of these were a single strain (USA300-0114). SCCmec type IV and the Panton-Valentine leukocidin toxin gene were detected in 98 percent of MRSA isolates. Other toxin genes were detected rarely. Among the MRSA isolates, 95 percent were susceptible to clindamycin, 6 percent to erythromycin, 60 percent to fluoroquinolones, 100 percent to rifampin and trimethoprim-sulfamethoxazole, and 92 percent to tetracycline. Antibiotic therapy was not concordant with the results of susceptibility testing in 100 of 175 patients with MRSA infection who received antibiotics (57 percent). Among methicillin-susceptible S. aureus isolates, 31 percent were USA300 and 42 percent contained pvl genes. CONCLUSIONS MRSA is the most common identifiable cause of skin and soft-tissue infections among patients presenting to emergency departments in 11 U.S. cities. When antimicrobial therapy is indicated for the treatment of skin and soft-tissue infections, clinicians should consider obtaining cultures and modifying empirical therapy to provide MRSA coverage.
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Affiliation(s)
- Gregory J Moran
- Department of Emergency Medicine, Olive View-UCLA Medical Center, Sylmar, Calif 91342, USA.
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50
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Vlack S, Cox L, Peleg AY, Canuto C, Stewart C, Conlon A, Stephens A, Giffard P, Huygens F, Mollinger A, Vohra R, McCarthy JS. Carriage of methicillin-resistant Staphylococcus aureus in a Queensland Indigenous community. Med J Aust 2006; 184:556-9. [PMID: 16768661 DOI: 10.5694/j.1326-5377.2006.tb00379.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 04/10/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) carriage and infection among children living in an Indigenous community in Queensland. DESIGN, SETTING AND PARTICIPANTS Swabs for culture of S. aureus were collected from the nose, throat and skin wounds of primary school children. MAIN OUTCOME MEASURES MRSA carriage, antibiotic sensitivity, genotype, and presence of the virulence factor Panton-Valentine leukocidin (PVL); and epidemiological risk factors for MRSA carriage. RESULTS 92 (59%) of 157 eligible children were included in the study. Twenty-seven (29%) carried S. aureus; 14 of these (15% of total) carried MRSA. MRSA was isolated from 29% of wound swabs, 8% of nose swabs, and 1% of throat swabs. Fourteen of 15 MRSA isolates were sensitive to all non-beta-lactam antibiotics tested. Eight children (9%) carried CA-MRSA clonal types: six carried the Queensland clone (ST93), and two carried the South West Pacific clone (ST30). All these isolates carried the virulence factor PVL. The remaining six children carried a hospital-associated MRSA strain (ST5), negative for PVL. CONCLUSIONS We have identified a high prevalence of CA-MRSA carriage in school children from a Queensland Indigenous community. In this setting, antibiotics with activity against CA-MRSA should be considered for empiric therapy of suspected staphylococcal infection. Larger community-based studies are needed to improve our understanding of the epidemiology of CA-MRSA, and to assist in the development of therapeutic guidelines for this important infection.
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Affiliation(s)
- Susan Vlack
- School of Population Health, University of Queensland, Brisbane, QLD
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