Prevalence of Panton-Valentine Leukocidin (PVL) and Antimicrobial Resistance in Community-Acquired Clinical Staphylococcus aureus in an Urban Gambian Hospital: A 11-Year Period Retrospective Pilot
Prevalence of Panton-Valentine Leukocidin (PVL) and Antimicrobial Resistance in Community-Acquired Clinical Staphylococcus aureus in an Urban Gambian Hospital: A 11-Year Period Retrospective Pilot
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DOI：
10.3389/fcimb.2019.00170
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发表时间：
2019-05-22
影响因子：
5.7
通讯作者：
Secka, Ousman
中科院分区：
文献类型：
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作者：
Darboe, Saffiatou;Dobreniecki, Sarah;Secka, Ousman
背景：金黄色葡萄球菌是人类的主要病原体。潘顿-瓦伦丁杀白素(PVL)是由一些菌株产生的一种毒力因子，可导致白细胞溶解和组织坏死。PVL相关金黄色葡萄球菌(PVL-SA)主要引起皮肤和软组织感染(SSTI)，但也可引起侵袭性感染，如坏死性肺炎。它由社区相关的甲氧西林敏感金黄色葡萄球菌(CA-MSSA)和耐甲氧西林金黄色葡萄球菌(CA-MRSA)携带。本研究旨在确定冈比亚一家城市医院就诊患者中PVL-SA的患病率及相关的抗生素耐药性。方法：检索293例患者的临床金黄色葡萄球菌(70例侵袭性菌血症和223例非侵袭性SSTI)以及相关的临床记录数据。根据临床实验室标准协会(CLSI)的指南，采用纸片扩散法评估抗生素敏感性。结果：金黄色葡萄球菌分离株中PVL-SA占61.4%(180/293)。在冈比亚菌血症和金黄色葡萄球菌菌株中，PVL的患病率都很高。耐药率较低的有氯霉素(4.8%)、头孢西丁(2.4%)、环丙沙星(3.8%)、红霉素(8.9%)、庆大霉素(5.5%)、青霉素(92.5%)、四环素(41.0%)、新诺明(24.2%)。结论：在冈比亚金黄色葡萄球菌临床分离株中，PVL的表达水平较高。报告PVL-SA临床感染是必要的，以便能够监测这些菌株在人群中的临床影响，并指导预防PVL阳性CA-MRSA毒力菌株的传播。金黄色葡萄球菌(S.aureus)是一种主要的人类病原体，具有多种毒力因子。我们进行了一项回顾性分析，以调查临床金黄色葡萄球菌样本中这种毒力因子(PVL)的流行率。我们发现在我们的环境中患病率很高，但包括甲氧西林耐药性在内的抗菌素耐药性很低。
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-associatedmethicillin 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.SUMMARYStaphylococcus 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.