Severe community-acquired pneumonia caused by Panton-Valentine leukocidin-positive Staphylococcus aureus: first reported case in the United Kingdom

Klein, JL; Petrovic, Z.; Treacher, D.F.; Edgeworth, Jonathan

doi:10.1007/s00134-003-1844-6

Cited by 40 publications

(30 citation statements)

References 2 publications

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“…They also showed that the PVL genes were highly associated with primary cutaneous infections, especially furunculosis, confirming earlier findings by other workers who used double immunodiffusion to detect the toxin (7,8,35). More recently, cases of community-acquired pneumonia due to PVL-positive S. aureus have been reported in France (4,14,25), Sweden (32), The Netherlands (42), and the United Kingdom (23). In addition, the PVL genes have been identified as a stable marker of community-acquired methicillin-resistant S. aureus (MRSA) strains worldwide (41).…”

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confidence: 78%

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Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes in England and Wales: Frequency, Characterization, and Association with Clinical Disease

Holmes¹,

Ganner²,

McGuane³

et al. 2005

J Clin Microbiol

353

255

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Staphylococcus aureus isolates carrying the genes that encode for Panton-Valentine leucocidin (PVL), a highly potent toxin, have been responsible for recent outbreaks of severe invasive disease in previously healthy children and adults in the United States of America and Europe. To determine the frequency of PVL-positive isolates sent to the Staphylococcus Reference Unit (United Kingdom) for epidemiological purposes, we tested 515 isolates of S. aureus, and 8 (1.6%) were positive for the PVL locus. A further 470 isolates were selected to explore the association of PVL-positive S. aureus with clinical disease. Of these, 23 (4.9%) were PVL positive and most were associated with skin and soft tissue infections (especially abscesses). The PVL genes were also detected in isolates responsible for community-acquired pneumonia, burn infections, bacteremia, and scalded skin syndrome. Genotyping by pulsed-field gel electrophoresis and multilocus sequence typing revealed that the PVL-positive isolates were from diverse genetic backgrounds, although one prevalent clone of 12 geographically dispersed methicillin-resistant S. aureus (MRSA) isolates was identified (ST80). All 12 isolates were stapylococcal cassette chromosome mec type IVc, had an agr3 allele, and shared a common toxin gene profile (sea-see, seg-sej, eta, etb, and tst negative but etd positive). ST80 strains with similar genetic characteristics have been responsible for community-acquired infections in France and Switzerland. The remaining PVL-positive isolates were mostly methicillin-sensitive S. aureus and belonged to 12 different sequence types, including ST22 and ST30, which are closely related to the most prevalent MRSA clones in United Kingdom hospitals, EMRSA-15 and EMRSA-16, respectively.Staphylococcus aureus is a very successful hospital and community-acquired pathogen. It causes a broad spectrum of disease, from mild skin infections to more serious invasive infections, including septicemia, pneumonia, endocarditis, and deep-seated abscesses. Pathogenicity is related to a number of virulence factors that allow it to adhere to surfaces, invade or avoid the immune system, and cause harmful toxic effects to the host. These factors include cell surface components (e.g., protein A, fibronectin-binding protein, collagen-binding protein, and clumping factor), and exoproteins (e.g., enterotoxins, exfoliatins, toxic shock syndrome toxin, and Panton-Valentine leucocidin [PVL]).PVL is a pore-forming cytotoxin that targets human and rabbit mononuclear and polymorphonuclear cells (37). When injected intradermally into rabbits, it induces severe inflammatory lesions, leading to capillary dilation, chemotaxis, polymorphonuclear karyorrhexis, and skin necrosis (44). Studies have shown that its toxic effect results from the synergistic action of two separate exoproteins, namely, LukS-PV and LukF-PV. These proteins are encoded by two contiguous and cotranscribed genes (lukS-PV and lukF-PV) (36), which are carried on temperate bacteriophages (20). Lysogenic conversion of...

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confidence: 78%

“…In addition, PVL-positive patients were more likely to develop hemoptysis and leucopenia. Similar cases of rapidly (23,32,42). In the present study, PVL genes were detected in 11% (4/37) of S. aureus strains responsible for pneumonia.…”

Section: Discussionmentioning

confidence: 87%

Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes in England and Wales: Frequency, Characterization, and Association with Clinical Disease

Holmes¹,

Ganner²,

McGuane³

et al. 2005

J Clin Microbiol

353

255

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“…However, they are found in a very high proportion of newly emerging CA-MRSA strains, with rates of 77% to 100%, as reported in various studies (19,20,26). The presence of PVL in S. aureus appears to be associated with increased disease severity, ranging from cutaneous infection requiring surgical drainage to severe chronic osteomyelitis and deadly necrotizing pneumonia (7,10,11,14,17,18). In the future, screening for the PVL virulence factor in S. aureus may become a routine laboratory procedure (5).…”

mentioning

confidence: 80%

“…A rapidly increasing prevalence of serious CA-MRSA infections and deaths has been reported worldwide (7,10,11,14,17,18), and a simple and rapid method of screening for the identification of S. aureus isolates carrying PVL genes is a crucial first step in controlling the dissemination of this potentially virulent pathogen. Very recently, several groups have developed effective real-time PCR assays for the detection of the PVL genes, alone or in combination with the mecA, spa, or nuc gene (4,13,16,21,23).…”

mentioning

confidence: 99%

Novel Multiplex PCR Assay for Detection of the Staphylococcal Virulence Marker Panton-Valentine Leukocidin Genes and Simultaneous Discrimination of Methicillin-Susceptible from -Resistant Staphylococci

et al. 2006

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“…1 Despite awareness that PVL-producing S. aureus causes mainly recurrent skin infections since 1932, a first case of necrotising pneumonia in the UK was described in 2003. 2 Unlike S. aureus pneumonia seen in elderly patients with a number of preexisting comorbidities, this PVL-producing strain of S. aureus tends to affect immunocompetent children and young adults. Although both of our cases involved MSSA, 47% of isolates have been found to be S. aureus resistant to methicillin (MRSA), 3 so empirical treatment must cover for this possibility.…”

Section: Discussionmentioning

confidence: 99%

Not your typical pneumonia

et al. 2013

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Severe community-acquired pneumonia caused by Panton-Valentine leukocidin-positive Staphylococcus aureus: first reported case in the United Kingdom

Cited by 40 publications

References 2 publications

Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes in England and Wales: Frequency, Characterization, and Association with Clinical Disease

Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes in England and Wales: Frequency, Characterization, and Association with Clinical Disease

Novel Multiplex PCR Assay for Detection of the Staphylococcal Virulence Marker Panton-Valentine Leukocidin Genes and Simultaneous Discrimination of Methicillin-Susceptible from -Resistant Staphylococci

Not your typical pneumonia

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