Journal Article

In Vitro Production of Panton-Valentine Leukocidin among Strains of Methicillin-Resistant <i>Staphylococcus aureus</i> Causing Diverse Infections

Stephanie M. Hamilton, Amy E. Bryant, Karen C. Carroll, Vivian Lockary, Yongsheng Ma, Eric McIndoo, Loren G. Miller, Francoise Perdreau-Remington, John Pullman, George F. Risi, Daniel B. Salmi and Dennis L. Stevens

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 12, pages 1550-1558
Published in print December 2007 | ISSN: 1058-4838
Published online December 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/523581
In Vitro Production of Panton-Valentine Leukocidin among Strains of Methicillin-Resistant Staphylococcus aureus Causing Diverse Infections

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Background.Community-acquired methicillin-resistant Staphylococcus aureus strains have recently been associated with severe necrotizing infections. Greater than 75% of these strains carry the genes for Panton-Valentine leukocidin (PVL), suggesting that this toxin may mediate these severe infections. However, to date, studies have not provided evidence of toxin production.

Methods.Twenty-nine community-acquired methicillin-resistant Staphylococcus aureus and 2 community-acquired methicillin-susceptible S. aureus strains were collected from patients with infections of varying severity. Strains were analyzed for the presence of lukF-PV and SCCmecA type. PVL production in lukF-PV gene–positive strains was measured by ELISA, and the amount produced was analyzed relative to severity of infection.

Results.Only 2 of the 31 strains tested, 1 methicillin-resistant Staphylococcus aureus abscess isolate and 1 nasal carriage methicillin-susceptible S. aureus isolate, were lukF-PV negative. All methicillin-resistant Staphylococcus aureus strains were SCCmec type IV. PVL was produced by all strains harboring lukF-PV, although a marked strain-to-strain variation was observed. Twenty-six (90%) of 29 strains produced 50–350 ng/mL of PVL; the remaining strains produced PVL in excess of 500 ng/mL. The quantity of PVL produced in vitro did not correlate with severity of infection.

Conclusions.Although PVL likely plays an important role in the pathogenesis of these infections, its mere presence is not solely responsible for the increased severity. Factors that up-regulate toxin synthesis in vivo could contribute to more-severe disease and worse outcomes in patients with community-acquired methicillin-resistant Staphylococcus aureus infection.

Journal Article.  4852 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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