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Staphylococcus aureus abscesses: methicillin-resistance or Panton-Valentine leukocidin presence?
  1. Marta Barrios López,
  2. Carmen Gómez González,
  3. Mª Ángeles Orellana,
  4. Fernando Chaves,
  5. Pablo Rojo
  1. Department of Paediatrics, Hospital Universitario12 de Octubre de Madrid, Madrid, Spain
  1. Correspondence to Dr Marta Barrios López., C/ Braganza 19 3° izquierda. 28025 Madrid; mbarrioslopez{at}yahoo.es

Abstract

Introduction Panton-Valentine leukocidin (PVL) is a toxin associated with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) worldwide and also occurs in community-associated methicillin-susceptible S aureus (CA-MSSA) strains. The aims of the study were to determine the prevalence of PVL in community-onset S aureus skin and soft-tissue infections (SSTIs) and to analyse the influence of methicillin resistance and PVL presence on the clinical characteristics of these infections.

Patients and methods We prospectively enrolled all children with S aureus community-onset SSTIs attending the emergency department of a tertiary hospital between 2007 and 2009.

Results A total of 142 S aureus SSTIs were identified, 46 (32%) were PVL positive. The proportion of subjects in each group was: 89 (63%) PVL-MSSA, 33 (23%) PVL+MSSA, 13 (9%) PVL+MRSA and 7 (5%) PVL-MRSA. PVL+infections were more frequently abscesses (63% vs 39%, p<0.01), and more often required incision and drainage (p<0.01) and hospital admission (46% vs 26%, p=0.02). MRSA infections were also more frequently associated with abscesses but in a multivariable analysis only PVL remained independently related (OR 2.33; 95% CI 1.10 to 4.90).

Conclusions Our study found a high prevalence of PVL presence in community-onset S aureus SSTIs in children in Spain. This toxin is associated with more abscess formation, regardless of methicillin resistance.

  • Microbiology
  • Infectious Diseases
  • Paediatrics

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