The association between Staphylococcus aureus strains carrying panton-valentine leukocidin genes and the development of deep-seated follicular infection.
The association between Staphylococcus aureus strains carrying panton-valentine leukocidin genes and the development of deep-seated follicular infection.
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DOI：
10.1086/427290
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发表时间：
2005-02
期刊：
影响因子：
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通讯作者：
O. Yamasaki;J. Kaneko;S. Morizane;H. Akiyama;J. Arata;S. Narita;J. Chiba;Y. Kamio;K. Iwatsuki
中科院分区：
文献类型：
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作者：
O. Yamasaki;J. Kaneko;S. Morizane;H. Akiyama;J. Arata;S. Narita;J. Chiba;Y. Kamio;K. Iwatsuki
背景：白血球蛋白(PVL)主要与坏死性化脓性病变有关，如皮肤和皮下组织中的红疹和脓肿，但也从社区获得性重症坏死性肺炎患者中分离出来。然而，由产生PVL的金黄色葡萄球菌引起的疱疹的临床表现和患者背景的作用尚不完全清楚。方法采用聚合酶链式反应扩增方法对161株金黄色葡萄球菌进行PVL基因检测。我们分析了所有从苔藓分离的PVL基因阳性菌株的皮肤表现、患者背景特征和细菌学标志，包括凝固酶类型、mecA基因的存在和毒素谱，并将这些结果与PVL基因阴性菌株的结果进行了比较。结果40株金黄色葡萄球菌中16株(40%)、7株炭疽分离株中2株(28%)、7株脓肿分离株中1株(14%)、20株毛囊炎分离株中1株(5%)携带PVL基因。PVL基因阳性的金黄色葡萄球菌通常会引起多个(而不是单个)皮疹，这种皮疹通常与皮损周围更强烈的红斑有关。PVL基因阳性菌株分离自没有潜在疾病的年轻人，而PVL基因阴性菌株分离自各种全身并发症，包括糖尿病、白血病和自身免疫性疾病。结论PVL基因阳性金黄色葡萄球菌与多发性红斑的发生有关，尤其是在健康的青壮年。了解PVL基因阳性菌株所致真菌的特征，有助于预防严重系统性感染的发生。
BACKGROUND Panton-Valentine leukocidin (PVL) is mainly associated with necrotic suppurative lesions, such as furuncles and abscesses in the skin and subcutaneous tissue, but it has also been isolated from patients with community-acquired, severe, necrotizing pneumonia. However, the clinical manifestations of furuncles caused by PVL-producing Staphylococcus aureus and the role of patients' background are not fully understood. METHODS We used polymerase chain reaction amplification to test for the PVL gene in 161 strains of S. aureus isolated from suppurative skin lesions. For all PVL gene-positive strains isolated from furuncles, we analyzed cutaneous manifestations, patient background characteristics, and bacteriological markers, including coagulase types, presence of the mecA gene, and toxin profiles, and we compared these results with those for PVL gene-negative strains. RESULTS PVL genes were detected in 16 (40%) of the 40 S. aureus strains isolated from furuncles, 2 (28%) of the 7 strains isolated from carbuncles, 1 (14%) of the 7 strains isolated from abscesses, and 1 (5%) of the 20 strains isolated from folliculitis. PVL gene-positive S. aureus usually causes multiple (rather than single) furuncles, and such furuncles are usually associated with more-intense erythema around the lesions. PVL gene-positive strains were isolated from young adults without underlying diseases, whereas PVL gene-negative strains were isolated from patients with various systemic complications, including diabetes, leukemia, and autoimmune diseases. CONCLUSIONS PVL gene-positive S. aureus strains are involved in the development of multiple furuncles with more-intense erythema, particularly in healthy young adults. An understanding of the characteristics of furuncles due to PVL gene-positive strains might be useful for preventing the development of the severe systemic infections.