Background: The role of Panton-Valentine leukocidin (PVL) in skin and soft-tissue infections is not clear. Objective: Our purpose was to determine the prevalence of PVL gene carriage among Staphylococcus aureus strains isolated from primary and secondary skin abscesses. Methods: A prospective study was conducted. From July 2003 to June 2008, S. aureus isolates from skin abscesses were screened for the PVL genes. The abscesses were considered primary if they occurred on previously healthy skin and secondary in all other cases. Results: Fifty-seven patients presenting with S. aureus skin abscesses were included in the study. The PVL genes were detected in 40 (70%) of the 57 S. aureus isolates. Thirty-eight (92.7%) of the 41 primary skin abscesses were due to PVL-positive strains, compared to only 2 (12.5%) of the 16 secondary skin abscesses (p < 0.001). Conclusions: Primary skin abscesses are mainly caused by PVL-positive S. aureus strains.

Keywords:
Staphylococcus aureus, Panton-Valentine leukocidin, Abscess, Staphylococcal skin infection, Skin infection
1.
Stevens DL, Bisno AL, Chambers HF, Everett ED, Dellinger P, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan EL, Montoya JG, Wade JC, Infectious Diseases Society of America; Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis 2005;41:1373–1406.
2.
Ladhani S, Joannou CL, Lochrie DP, Evans RW, Poston SM: Clinical, microbial, and biochemical aspects of the exfoliative toxins causing staphylococcal scalded-skin syndrome. Clin Microbiol Rev 1999;12:224–242.
3.
Gravet A, Couppie P, Meunier O, Clyti E, Moreau B, Pradinaud R, Monteil H, Prevost G: Staphylococcus aureus isolated in case of impetigo produce both epidermolysin A or B and LukE-LukD in 78% of 131 retrospective and prospective cases. J Clin Microbiol 2001;39:4349–4356.
4.
Couppie P, Cribier B, Prevost G: Leukocidin from Staphylococcus aureus and cutaneous infections: an epidemiologic study. Arch Dermatol 1994;130:1208–1209.
5.
Prevost G, Couppie P, Prevost P, Gayet S, Petiau P, Cribier B, Monteil H, Piemont Y: Epidemiological data on Staphylococcus aureus strains producing synergohymenotropic toxins. J Med Microbiol 1995;42:237–245.
6.
Yamasaki O, Kaneko J, Morizane S, Akiyama H, Arata J, Narita S, Chiba JI, Kamio Y, Iwatsuki K: The Association between Staphylococcus aureus strains carrying Panton-Valentine leukocidin genes and the development of deep-seated follicular infection. Clin Infect Dis 2005;40:381–385.
7.
Lina G, Piemont Y, Godail-Gamot F, et al: Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999;29:1128–1132.
8.
Woodin AM: Staphylococcal leucocidin; in Cohen JO (ed): The Staphylococci. New York, Wiley Interscience, 1972, pp 281–299.
9.
König B, Prévost G, Piémont Y, König W: Effects of Staphylococcus aureus leukocidins on inflammatory mediator release from human granulocytes. J Infect Dis 1995;171:607–613.
10.
Genestier AL, Michallet MC, Prévost G, Bellot G, Chalabreysse L, Peyrol S, Thivolet F, Etienne J, Lina G, Vallette FM, Vandenesch F, Genestier L: Staphylococcus aureus Panton-Valentine leukocidin directly targets mitochondria and induces Bax-independent apoptosis of human neutrophils. J Clin Invest 2005;115:3117–3127.
11.
Cribier B, Prévost G, Couppié P, Finck-Barbançon V, Grosshans E, Piémont Y: Staphylococcus aureus leukocidin: a new virulence factor in cutaneous infections? Dermatology 1992;185:175–180.
12.
Ward PD, Turner WH: Identification of staphylococcal Panton-Valentine leukocidin as a potent dermonecrotic toxin. Infect Immun 1980;27:393–397.
13.
Badiou C, Dumitrescu O, Croze M, Gillet Y, Dohin B, Allaouchiche B, Etienne J, Vandenesch F, Lina G: Panton-Valentine leukocidin is expressed at toxic levels in human skin abscesses. Clin Microbiol Infect 2008;14:1180–1183.
14.
Voyich JM, Otto M, Mathema B, Braugton KR, Whitney AR, Welty D, Long RD, Dorward DW, Gardner DJ, Lina G, Kreiswirth BN, De Leo FR: Is Panton-Valentine leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease? J Infect Dis 2006;194:1761–1770.
15.
Bubeck Wardenburg J, Palazzolo-Ballance AM, Otto M, Schneewind O, DeLeo FR: Panton-Valentine leukocidin is not a virulence determinant in murine models of community-associated methicillin-resistant Staphylococcus aureus. J Infect Dis 2008;198:1166–1170.
16.
Del Giudice P, Blanc V, Durupt F, Bes M, Martinez JP, Counillon E, Lina G, Vandenesch F, Etienne J: Emergence of two populations of methicillin-resistant Staphylococcus aureus with distinct epidemiological, clinical and biological features, isolated from patients with community-acquired skin infections. Br J Dermatol 2006;154:118–124.
17.
Jarraud S, Mougel C, Thioulouse J, Lina G, Meugnier H, Forey F, Nesme X, Etienne J, Vandenesch F: Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun 2002;70:631–641.
18.
Murakami K, Minamide W, Wada K, Nakamura E, Teraoka H, Watanabe S: Identification of methicillin-resistant strains of staphylococci by polymerase chain reaction. J Clin Microbiol 1991;29:2240–2244.
19.
Durupt F, Mayor L, Bes M, Reverdy ME, Vandenesch F, Thomas L, Etienne J: Prevalence of Staphylococcus aureus toxins and nasal carriage in furuncles and impetigo. Br J Dermatol 2007;157:1161–1167.
20.
Issartel B, Tristan A, Lechevallier S, Bruyère F, Lina G, Garin B, Lacassin F, Bes M, Vandenesh F, Etienne J: Frequent carriage of Panton-Valentine leucocidin genes by Staphylococcus aureus isolates from surgically drained abscesses. J Clin Microbiol 2005;43:3203–3207.
21.
Nolte O, Haag H, Zimmerman A, Geiss HK: Staphylococcus aureus positive for Panton-Valentine leukocidin genes but susceptible to methicillin in patients with furuncles. Eur J Clin Microbiol Infect Dis 2005;24:477–479.
22.
Jappe U, Heuck D, Strommenger B, Wendt C, Werner G, Altmann D, Witte W: Staphylococcus aureus in dermatology outpatients with special emphasis on community-associated methicillin-resistant strains. J Invest Dermatol 2008;128:2655–2664.
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2009
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