Abstract
Background: Staphylococcus aureus is a major human pathogen. Panton-Valentine leukocidin (PVL) is a virulence factor produced by some strains that causes leukocyte lysis and tissue necrosis. PVL-associated S. aureus (PVL-SA) predominantly causes skin and soft-tissue infections (SSTIs) but can also cause invasive infections such as necrotizing pneumonia. It is carried by both community-associated methicillin susceptible S. aureus (CA-MSSA) and methicillin resistant S. aureus (CA-MRSA). This study aims to determine the prevalence of PVL-SA among patients seen at an urban Gambian hospital and associated antibiotic resistance.Methods: Archived clinical S. aureus (70 invasive bacteraemia and 223 non-invasive SSTIs) from 293 patients were retrieved as well as relevant data from clinical records where available. Antibiotic susceptibility was assessed using disc diffusion according to Clinical Laboratory Standards Institute (CLSI) guidelines. Genomic DNA was extracted and the presence of lukF and lukS PVL genes was detected by conventional gel-based PCR.Result: PVL-SA strains accounted for 61.4% (180/293) of S. aureus isolates. PVL prevalence was high in both Gambian bacteraemia and SSTIs S. aureus strains. Antimicrobial resistance was low and included chloramphenicol (4.8%), cefoxitin (2.4%), ciprofloxacin (3.8%), erythromycin (8.9%), gentamicin (5.5%) penicillin (92.5%), tetracycline (41.0%), and sulfamethoxazole-trimethoprim (24.2%). There was no association of PVL with antimicrobial resistance.Conclusion: PVL expression is high among clinical S. aureus strains among Gambian patients. Reporting of PVL-SA clinical infections is necessary to enable the monitoring of the clinical impact of these strains in the population and guide prevention of the spread of virulent PVL-positive CA-MRSA strains.SUMMARY Staphylococcus aureus (S. aureus) is a major human pathogen with several virulence factors. We performed a retrospective analysis to investigate the prevalence of one such virulence factor (PVL) amongst clinical S. aureus samples. We found a high prevalence in our setting but antimicrobial resistance including methicillin resistance was low.
Highlights
Staphylococcus aureus (S. aureus) is a major human pathogen causing infections ranging from mild skin and soft-tissue infections to life-threatening sepsis, and implicated in both community acquired (CA) and healthcare-associated (HA) infections with significant morbidity and mortality (BoyleVavra and Daum, 2007; Breurec et al, 2011a; Ozekinci et al, 2014)
Panton-Valentine leukocidin (PVL)-associated S. aureus (PVL-SA) infection is commonly associated with community-acquired methicillin resistant S. aureus (CAMRSA) (Asiimwe et al, 2017), but outbreaks due to PVL-pos methicillin-susceptible S. aureus (MSSA) strains have been reported in close community settings (Boubaker et al, 2004; Rasigade et al, 2010)
This study aims to determine the PVL prevalence and its association with antibiotic resistance in S. aureus isolated from clinical strains between 2005 and 2015 in an urban hospital of The Gambia
Summary
Staphylococcus aureus (S. aureus) is a major human pathogen causing infections ranging from mild skin and soft-tissue infections to life-threatening sepsis, and implicated in both community acquired (CA) and healthcare-associated (HA) infections with significant morbidity and mortality (BoyleVavra and Daum, 2007; Breurec et al, 2011a; Ozekinci et al, 2014). The pathogenesis of S. aureus is mediated by several cell surface and secreted virulence factors One such virulence factor, Panton-Valentine leukocidin (PVL) is a two-component toxin, that induces pore formation in the leukocyte cell membrane complement receptors (Rasigade et al, 2010). Panton-Valentine leukocidin (PVL) is a two-component toxin, that induces pore formation in the leukocyte cell membrane complement receptors (Rasigade et al, 2010) These two genes (LukS-PV and LukF-PV) encode two proteins which are co-transcribed and secreted separately to form a complete heptavalent leukocidin (Boyle-Vavra and Daum, 2007; Rasigade et al, 2010). PVL-associated S. aureus (PVL-SA) predominantly causes skin and soft-tissue infections (SSTIs) but can cause invasive infections such as necrotizing pneumonia It is carried by both community-associated methicillin susceptible S. aureus (CA-MSSA) and methicillin resistant S. aureus (CA-MRSA). This study aims to determine the prevalence of PVL-SA among patients seen at an urban Gambian hospital and associated antibiotic resistance
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