Irrelevance of Panton-Valentine leukocidin in hidradenitis suppurativa: results from a pilot, observational study

Abstract

Panton-Valentine leukocidin (PVL) appears to be a virulence factor which, among others, can exacerbate the pathogenicity of Staphylococcus aureus infections, especially inducing severe necrotic, deep-seated skin infections, abscesses, and recurrences. These peculiarities have some overlaps with hidradenitis suppurativa (HS). Our main aim was to assess if S. aureus producing PVL could have some role in influencing clinical features and/or course of HS, specifically in the suppuration and recurrence of lesions. This pilot, mono-centric, observational study included all adult subjects affected with HS consecutively referring to our HS clinic over a 3-month period. Clinically evident suppuration and at least 2 weeks wash out from any antibiotic were the main inclusion criteria. Purulent material from HS skin lesions was collected with swabs in order to isolate micro-organisms, with specific regard to S. aureus. Detection of PVL was performed by real-time quantitative PCR (RT-qPCR). We also analyzed purulent material from suppurative skin lesions other than HS, as a control. Thirty HS patients were included; 29 purulent lesions (96.7%) harbored at least one bacterial species. Five (16.7%) swab samples were positive for S. aureus, none of which was positive for PVL genes. Among the 30 purulent disorders included as controls, 8 (26.3%) were positive for S. aureus; of these, 4 strains (50%) expressed LPV. The study results seem to exclude the pathogenetic involvement of S. aureus producing PVL in HS; as a result, PVL does not seem to represent a potential target in the future development of HS treatments.

Consistency of Bacterial Triggers in the Pathogenesis of Hidradenitis Suppurativa

“…Interestingly, among the 5 S. aureus strains isolated, none of them were positive for PVL, in contrast to the control group, where 26.3% tested positive for PVL. The study results seemingly point against a pathogenic involvement of S. aureus producing PVL in HS [ 20 ].…”

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin

“…Prior to nucleic acid extraction and PCR analysis, the SA culture suspensions were kept at 4 • C. As previously mentioned, bacterial DNA was extracted using the commercial kit RIDA ® GENE PVL test, and real-time quantitative PCR (RT-qPCR) analysis was performed by amplifying a PVL-specific fragment (Panton-Valentine Leukocidine lukF-PV). [23]. In a tube, SA culture suspensions were added with lysis Buffer (200 µL).…”

“…The remaining two cases of PJI caused by the SA PVL-producing strains were chronic PJIs treated with a revision arthroplasty (one and two stage, respectively) and targeted antibiotic therapy for 12 weeks; these resulted in a 100% eradication rate in a medium follow-up of 24 months (range [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The surgical treatment, antibiotic regimens, and outcome of the total PJI cases are shown in Table S3.…”

“…Other invasive diseases, such as pneumonia, musculoskeletal illness, and bacteremia, are much less common and are only secondarily associated with PVL. In contrast, infection with a PVL-positive strain does not seem to have any bearing on how staphylococcal pneumonia, adult bacteremia, or hidradenitis suppurativa (HS) turn out clinically [ 21 , 23 ]. Over the past ten years, SA PVL-positive strains have been linked to an upsurge in pediatric bone and joint infections [ 24 , 25 ].…”

The Clinical Relevance of the Microbiome in Hidradenitis Suppurativa: A Systematic Review

“…[69]. Conflicting results have been obtained with regard to the correlation of HS severity and S. aureus [69,91,135]. ASCA positivity has also been associated with severe (Hurley Stage 3) disease [116].…”