Tags

Type your tag names separated by a space and hit enter

Panton-Valentine leukocidin-positive Staphylococcus aureus in skin and soft tissue infections from primary care patients.
Clin Microbiol Infect. 2020 Jun 30 [Online ahead of print]CM

Abstract

OBJECTIVES

To characterize deep skin and soft tissue infections (dSSTI) caused by Panton-Valentine leukocidin (PVL)-positive versus PVL-negative Staphylococcus aureus isolates.

METHODS

We performed a retrospective analysis of patients' records including S. aureus isolates from outpatients with dSSTI. Samples had been submitted by primary care physicians, i.e. general practitioners, surgeons, dermatologists and paediatricians, located in Berlin, Germany, in 2007-2017. Bacterial isolates were identified and tested for antimicrobial susceptibility by VITEK 2; PVL was detected by PCR.

RESULTS

In total, 1199 S. aureus isolates from 1074 patients with dSSTI were identified, and 613 (51.1%) of 1199 samples were PVL+. The median age of patients with PVL+S. aureus was lower than in patients with PVL- S. aureus (34 years, range 0-88 years, vs. 44 years, range 0-98 years; p < 0.0001). PVL was associated with repeated/multiple samples compared to single sample submission (69/92, 75% vs. 448/982, 45.6%, p < 0.0001; odds ratio (OR), 3.6; 95% confidence interval (CI), 2.2-5.8). Interestingly, the highest PVL positivity rate was found in isolates from gluteal (82/108, 75.9%; OR, 3.6; 95% CI, 2-5) or axillary (76/123, 61.8%; OR, 2; 95% CI, 1.1-3.3) localizations compared to isolates from the arm. The PVL positivity rate did not increase over time. Yet we noticed an increase in the trimethoprim/sulfamethoxazole (SXT) resistance rate in PVL+ isolates, mainly methicillin-sensitive S. aureus, when considering SXT resistance rates of 2007-2012 versus 2013-2017 (35/226, 15.5% vs. 74/289, 25.6%; p 0.01).

CONCLUSIONS

In outpatients, gluteal and axillary dSSTI are indicative of PVL+S. aureus. Providing SXT as a complementary treatment for dSSTI should be based on susceptibility testing.

Authors+Show Affiliations

MVZ Labor 28, Berlin, Germany. Electronic address: friesen@labor28.de.MVZ Labor 28, Berlin, Germany.MVZ Labor 28, Berlin, Germany.MVZ Labor 28, Berlin, Germany.MVZ Labor 28, Berlin, Germany.Institute of Medical Microbiology, University Hospital Münster, Münster, Germany.MVZ Labor 28, Berlin, Germany.MVZ Labor 28, Berlin, Germany; Institute of Microbiology and Infection Immunology, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32619735

Citation

Friesen, J, et al. "Panton-Valentine Leukocidin-positive Staphylococcus Aureus in Skin and Soft Tissue Infections From Primary Care Patients." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020.
Friesen J, Neuber R, Fuhrmann J, et al. Panton-Valentine leukocidin-positive Staphylococcus aureus in skin and soft tissue infections from primary care patients. Clin Microbiol Infect. 2020.
Friesen, J., Neuber, R., Fuhrmann, J., Kietzmann, H., Wenzel, T., Schaumburg, F., Müller, M., & Ignatius, R. (2020). Panton-Valentine leukocidin-positive Staphylococcus aureus in skin and soft tissue infections from primary care patients. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. https://doi.org/10.1016/j.cmi.2020.06.029
Friesen J, et al. Panton-Valentine Leukocidin-positive Staphylococcus Aureus in Skin and Soft Tissue Infections From Primary Care Patients. Clin Microbiol Infect. 2020 Jun 30; PubMed PMID: 32619735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Panton-Valentine leukocidin-positive Staphylococcus aureus in skin and soft tissue infections from primary care patients. AU - Friesen,J, AU - Neuber,R, AU - Fuhrmann,J, AU - Kietzmann,H, AU - Wenzel,T, AU - Schaumburg,F, AU - Müller,M, AU - Ignatius,R, Y1 - 2020/06/30/ PY - 2020/03/24/received PY - 2020/06/24/revised PY - 2020/06/25/accepted PY - 2020/7/4/pubmed PY - 2020/7/4/medline PY - 2020/7/4/entrez KW - Deep skin and soft tissue infections KW - Epidemiology KW - Panton-Valentine leukocidin KW - Primary care patients KW - Staphylococcus aureus JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin. Microbiol. Infect. N2 - OBJECTIVES: To characterize deep skin and soft tissue infections (dSSTI) caused by Panton-Valentine leukocidin (PVL)-positive versus PVL-negative Staphylococcus aureus isolates. METHODS: We performed a retrospective analysis of patients' records including S. aureus isolates from outpatients with dSSTI. Samples had been submitted by primary care physicians, i.e. general practitioners, surgeons, dermatologists and paediatricians, located in Berlin, Germany, in 2007-2017. Bacterial isolates were identified and tested for antimicrobial susceptibility by VITEK 2; PVL was detected by PCR. RESULTS: In total, 1199 S. aureus isolates from 1074 patients with dSSTI were identified, and 613 (51.1%) of 1199 samples were PVL+. The median age of patients with PVL+S. aureus was lower than in patients with PVL- S. aureus (34 years, range 0-88 years, vs. 44 years, range 0-98 years; p < 0.0001). PVL was associated with repeated/multiple samples compared to single sample submission (69/92, 75% vs. 448/982, 45.6%, p < 0.0001; odds ratio (OR), 3.6; 95% confidence interval (CI), 2.2-5.8). Interestingly, the highest PVL positivity rate was found in isolates from gluteal (82/108, 75.9%; OR, 3.6; 95% CI, 2-5) or axillary (76/123, 61.8%; OR, 2; 95% CI, 1.1-3.3) localizations compared to isolates from the arm. The PVL positivity rate did not increase over time. Yet we noticed an increase in the trimethoprim/sulfamethoxazole (SXT) resistance rate in PVL+ isolates, mainly methicillin-sensitive S. aureus, when considering SXT resistance rates of 2007-2012 versus 2013-2017 (35/226, 15.5% vs. 74/289, 25.6%; p 0.01). CONCLUSIONS: In outpatients, gluteal and axillary dSSTI are indicative of PVL+S. aureus. Providing SXT as a complementary treatment for dSSTI should be based on susceptibility testing. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/32619735/Panton-Valentine_leukocidin_positive_Staphylococcus_aureus_in_skin_and_soft_tissue_infections_from_primary_care_patients L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(20)30375-X DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.