Epidemiological, clinical, outcome and antibiotic susceptibility differences between PVL positive and PVL negative Staphylococcus aureus infections in Western Australia: a case control study

P. Boan; H-L Tan; J. Pearson; G. Coombs; C.H Heath; J. Robinson

doi:10.1186/s12879-014-0742-6

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Epidemiological, clinical, outcome and antibiotic susceptibility differences between PVL positive and PVL negative Staphylococcus aureus infections in Western Australia: a case control study

Journal article

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Epidemiological, clinical, outcome and antibiotic susceptibility differences between PVL positive and PVL negative Staphylococcus aureus infections in Western Australia: a case control study

P. Boan, H-L Tan, J. Pearson, G. Coombs, C.H Heath and J. Robinson

BMC Infectious Diseases, Vol.15, Article Number: 10

2015

DOI: https://doi.org/10.1186/s12879-014-0742-6

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Abstract

Background Panton Valentine Leukocidin (PVL) has been associated with invasive Staphylococcus aureus soft tissue and pneumonic infections. Methods From September 2007 to January 2009 at Royal Perth Hospital we tested for the PVL gene in S. aureus isolates from an invasive site, a suspected PVL-related soft tissue infection and all MRSA isolates. We could access medical records for 141 PVL positive (PVL + ve) infections and compared these to a control group comprised of 148 PVL negative (PVL-ve) infections. Results In the PVL + ve group 62 isolates were MRSA (48 were ST93-MRSA-IV) and 79 isolates were methicillin-sensitive S. aureus, and in the PVL-ve group 56 were MRSA (50 were WA-MRSA strains) and 92 were methicillin-sensitive S. aureus. We found the presence of PVL to be significantly associated with younger age, aboriginality, intravenous drug use, community acquisition, shorter length of hospital stay and lower mortality at 1 year. Overall PVL + ve infections more often required surgical intervention (73.0% versus 44.6%, p < 0.001) and were less often polymicrobial (8.5% versus 41.2%, p < 0.001). PVL + ve isolates were more often susceptible to clindamycin (87.9% versus 73.0%, p = 0.002). Conclusions This study demonstrates that PVL + ve infections are associated with a distinct clinical picture, predominantly pyogenic skin and soft tissue infections often requiring surgery, disproportionately affecting patients who are younger, indigenous or with fewer health-care risk factors.

Details

Title: Epidemiological, clinical, outcome and antibiotic susceptibility differences between PVL positive and PVL negative Staphylococcus aureus infections in Western Australia: a case control study
Authors/Creators: P. Boan (Author/Creator) - Royal Perth Hospital
H-L Tan (Author/Creator) - Curtin University
J. Pearson (Author/Creator) - Royal Perth Hospital
G. Coombs (Author/Creator) - Royal Perth Hospital
C.H Heath (Author/Creator) - Royal Perth Hospital
J. Robinson (Author/Creator) - Royal Perth Hospital
Publication Details: BMC Infectious Diseases, Vol.15, Article Number: 10
Publisher: BioMed Central
Identifiers: 991005540517407891
Copyright: © 2015 Boan et al.
Murdoch Affiliation: Murdoch University
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.23 Antibiotics & Antimicrobials; 1.23.173 MRSA and VRE
Web Of Science research areas: Infectious Diseases
ESI research areas: Immunology