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  • Title: Clinical and Molecular Characterization of Panton-Valentine Leukocidin-Positive Invasive Staphylococcus aureus Infections in Korea.
    Author: Song KH, Kim ES, Park KH, Choi HJ, Kim KH, Lee S, Hwang JH, Choo EJ, Park Y, Lee EJ, Kim YK, Jeon MH, Moon C, Hwang JH, Park JS, Park KU, Choe PG, Bang JH, Oh MD, Kim HB, Korea INfectious Diseases (KIND) Study Group.
    Journal: Microb Drug Resist; 2019 Apr; 25(3):450-456. PubMed ID: 30379606.
    Abstract:
    AIM: Panton-Valentine leukocidin (PVL) is a virulent cytotoxin and an indicator of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection. In this study, we evaluated the prevalence and clinical and molecular characteristics of PVL-positive invasive S. aureus (ISA) infections in Korea. RESULTS: A collection of 1,962 nonduplicate clinical isolates were screened for multilocus sequence typing, staphylococcal cassette chromosome mec (SCCmec), accessory gene regulator typing, major toxins, and antimicrobial susceptibility. Twenty-eight (1.4%) PVL-positive S. aureus samples were found; of them 19 (67.9%) were MRSA (8 CA and 11 healthcare-associated infections). Seventeen patients (60.7%) were men (median age: 63 years; range: 13-93 years) and 12 patients (42.9%) had no underlying comorbidities. The most common infections were skin and skin structure infection (SSSI) and pneumonia. The 30-day mortality rate was 37.0%. The most common PVL-positive MRSA clones were ST8-SCCmec IVa and ST30-SCCmec IVc along with their single-locus variants. Antimicrobial susceptibility and toxin-gene profile differed according to the clone. CONCLUSIONS: ISA infections caused by PVL-positive strains are rare in Korea, with the two most common infections being SSSI and pneumonia. Our findings indicated that several PVL-positive MRSA clones, predominantly ST8-SCCmecIVa and ST30-SCCmecIVc, were circulating and causing sporadic cases of ISA infections in the community and hospital settings.
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