产杀白细胞素金黄色葡萄球菌感染的研究现状

国外多数回顾性研究发现产杀白细胞素(PVL)金黄色葡萄球菌感染有着特有的临床表现,特别是产PVL金黄色葡萄球菌相关性坏死性肺炎可能为一新现的临床疾病,由此PVL在金黄色葡萄球菌感染中的致病研究日益受到重视.本文就目前对产PVL金黄色葡萄球菌感染的致病机制、流行病学、检测和防治等问题研究作一综述.     

Panton-Valentine leukocidin-producing Staphylococcus aureus infections: report of 4 French cases

We report 4 cases of community-acquired infections due to Staphylococcus aureus producing Panton-Valentin leukocidin (SA-PVL) with uncommon multivisceral localizations. These cases highlight the need to screen for PVL in patients with serious staphylococcal infections. All patients were cured. Two of them received intravenous immunoglobulins in addition to antibiotics.     

Community-acquired pneumonia due to Panton-Valentine leukocidin-producing Staphylococcus aureus in an HIV-2-infected patient

Pneumonia caused by Panton-Valentine leukocidin-producing Staphylococcus aureus is associated with a high fatality rate. There have been few reported cases in HIV-1-co-infected patients. Here we report a fatal case of severe community-acquired pneumonia caused by Panton-Valentine leukocidin-producing S. aureus in a 45-year-old woman with HIV-2 infection.     

Fatal necrotizing pneumonia caused by Panton-Valentine leukocidin-producing hospital-acquired Staphylococcus aureus: a case report

Panton-Valentine leukocidin (PVL) is a cytotoxin which causes leukocyte destruction and tissue necrosis. Although it is produced by fewer than 5% of Staphylococcus aureus strains, PVL-producing S. aureus is emerging as a serious problem worldwide. There has been a marked increase in the incidence of necrotizing lung infections with a very high mortality associated with these strains. This report describes a fatal case of hospital-acquired necrotizing pneumonia caused by PVL-positive methicillin-susceptible S. aureus in a patient with a brain tumor.     

Panton-Valentine leukocidin-positive Staphylococcus aureus infections in returning travelers

Skin and soft tissue infections caused by Panton-Valentine leukocidin-producing strains of Staphylococcus aureus are emerging among travelers returning from the tropics. Here, we here present data on 15 affected individuals. Intrafamiliar spread was documented in one case, and occupational transmission was assumed in another. Spa typing of the strains revealed a broad spectrum of variants, but some were clonally related. Methicillin-resistant Staphylococcus aureus (MRSA) was found in three cases.     

Fatal Staphylococcus aureus haemorrhagic pneumonia producing Panton-Valentine leucocidin

We present 2 cases of community acquired S. aureus pneumonia carrying Panton Valentine leucocidin (PVL). These cases illustrate this clinical entity characterized by a younger and healthier population than usual staphylococcal pneumonias and complicated by a 75% mortality rate. We also discuss the diagnosis and therapeutic difficulties.     

Staphylococcus aureus skin/soft-tissue infections: the impact of SCCmec type and Panton-Valentine leukocidin

We assessed the role of Panton-Valentine leukocidin (PVL) and SCCmec type in community associated (CA) and healthcare associated (HC) Staphylococcus aureus (SA) skin/soft-tissue infections (STI). We prospectively monitored microbiology results (11 January 2005 to 6 January 2006), screened inpatients with SA in tissue samples or blood, and selected adults with STI. We recorded clinical/microbiological characteristics, and tested saved isolates for PVL genes (real time PCR) and SCCmec type (conventional multiplex PCR). We encountered 204 patients. MRSA strains that accounted for 70.5% CA and 66.0% HC cases, caused more abscesses (55.7% vs 29.7%; p =0.001) and were often PVL-positive (68.9% vs 4.8%; p <0.001). PVL-positive isolates caused more abscesses (72.9% vs 26.5%; p <0.001) but similar bacteremia (7.3% vs 7.1%). SCCmec IVa made up 95.8% of PVL-positive strains and accounted for 69.8% of the abscesses. SCCmec II caused higher mortality (14.8% vs 0-3.1%; p = 0.02). PVL was a predictor of abscesses (p <0.001). Predictors of bacteremia were age > or = 65 y (p =0.004), necrotizing infection (p =0.014), and head/neck location (p =0.05). These findings suggest that SCCmec type and PVL status influence STI manifestations and contribute to MRSA-MSSA differences. PVL is implicated in abscess formation but not bacteremia. Bacteremia is likely related to host condition and/or other virulence factors that were not studied.     

引起皮肤软组织感染的杀白细胞素阳性社区获得性耐甲氧西林金黄色葡萄球菌分子特征研究

目的 了解分离自临床皮肤和软组织感染(SSTIs)患者携带杀白细胞素基因(pvl)社区获得性耐甲氧西林金黄色葡萄球菌(pvl⁺-CA-MRSA)的分子特征。方法 从SSTIs患者中分离出92株CA-MRSA。采用聚合酶链反应(PCR)和测序检测pvl基因及其突变。pvl⁺-CA-MRSA菌株进行序列类型(STs)与克隆复合物(CCs)、葡萄球菌盒式染色体mec(SCCmec)、葡萄球菌蛋白基因(spa)多态性、辅助基因调控子(agr)位点、脉冲场凝胶电泳(PFGE)分型和多位点序列分型(MLST)。采用VITEK-2 Compact全自动微生物鉴定系统进行CA-MRSA药物敏感试验。结果 92株CA-MRSA中,24株(26.1%)为pvl⁺-CA-MRSA,其中91.7%(22/24)为pvl的H亚型,68株(73.9%)为未携带pvl基因CA-MRSA(pvl^--CA-MRSA)。24株pvl⁺-CA-MRSA中,共有8种STs和7种CCs,其中以ST59(62.5%,15...     

Prevalence of Panton-Valentine leukocidin genes and antimicrobic resistance in Staphylococcus aureus isolates from outpatients with skin and softtissue infections in Wuhan city

<正>Objective To estimate the prevalence of PantonValentine leukocidin(PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus(MSSA)isolated from outpatients with skin and soft-tissue infections(SSTIs)in Wuhan city.Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between2011 and 2013.The Kirby-Bauer's disk diffusion method     

Severe non-pneumonic necrotising infections in children caused by Panton-Valentine leukocidin producing Staphylococcus aureus strains

Two cases of infection with Panton-Valentine Leukocidin (PVL) producing strains of Staphylococcus aureus are reported. A 15-year-old insulin dependent diabetic developed toxic shock syndrome and an abscess in the deep tissue around his left hip. A 34-day-old infant presented with a right orbital cellulitis with an intra-orbital collection and septicaemia. In both cases PVL-producing strains of Staphylococcus aureus were isolated. Both surgery and prolonged antibiotic combination regimens were required to eradicate the infection. The cases reported here demonstrate the wide range of clinical presentations seen with PVL producing strains, which have so far been mainly associated with furuncles and necrotising pneumonia.     

Bacteremic Staphylococcus aureus pneumonia

Medical records of 44 consecutive patients with bacteremic Staphylococcus aureus pneumonia between 1980 to 1984 in a 750-bed community teaching hospital were reviewed. 36 patients (82%) were 60 years or older and the median age was in the 8th decade. There was no seasonal variation in the prevalence. The infection was hospital-acquired in 29 patients (66%). All patients had 1 or more (median 3) major underlying conditions. The chest roentgenogram was non-diagnostic; only 1 patient had empyema. Fever and leukocytosis were common. Many patients had renal insufficiency and hyperbilirubinemia. The overall mortality was 84%.