Skin and Soft Tissue Infections Caused by Different Genotypes of PVL-Positive Community-Acquired Methicillin-Resistant Staphylococcus aureus Strains

Jpn J Infect Dis. 2020 Jan 23;73(1):72-75. doi: 10.7883/yoken.JJID.2019.162. Epub 2019 Oct 31.

Abstract

Panton-Valentine leukocidin (PVL) is a causative agent of lethal necrotizing pneumonia and is associated with epidemic strains of community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA). PVL-producing strains have rarely been isolated in Japan. However, PVL-positive CA-MRSA has been isolated much more frequently in recent years. To investigate the relevance of pvl genes (lukS/F-PV) and clinical traits in epidemic S. aureus strains, we genotyped four PVL-positive CA-MRSA strains isolated from patients with skin and soft tissue infections and measured their susceptibility to antibiotics. Three of the isolates matched the genotype of the USA300 clone, which has predominantly been isolated in the USA. The remaining strain matched the ST217 genotype, and its spa type was identical to that of PVL-positive strains previously reported in India and China. Abscess drainage was necessary in all cases, and deep cutaneous ulcers were formed in three out of four cases regardless of the genotype. The ST217 genotype strain was resistant to clindamycin, in addition to quinolones, macrolides, and aminoglycosides. Thus, diagnostic determination of lukS/F-PV should be used as a guide for selecting the treatment regimen.

Keywords: CA-MRSA; Panton-Valentine leukocidin; USA300 clone; genotype.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Toxins / genetics
  • China
  • Community-Acquired Infections / microbiology*
  • Drug Resistance, Multiple, Bacterial*
  • Exotoxins / genetics
  • Genotype
  • Humans
  • India
  • Japan
  • Leukocidins / genetics
  • Male
  • Methicillin-Resistant Staphylococcus aureus / classification
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Middle Aged
  • Skin Ulcer / microbiology
  • Soft Tissue Infections / microbiology*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*

Substances

  • Anti-Bacterial Agents
  • Bacterial Toxins
  • Exotoxins
  • Leukocidins
  • Panton-Valentine leukocidin