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Family recurrent episodes of skin and soft-tissue infections by meticillin-susceptible Staphylococcus aureus carrying Panton-Valentine leukocidin

Abstract number: P1450

Álvarez-Martínez M., Marco F., Pitart C., Mensa J., Almela M., Martínez J., Soriano À., Jiménez de Anta M.

Objectives:Staphylococcus aureus is a common pathogen able of causing a variety of infections in humans. Pathogenicity is due to several virulence factors, one of them is Panton-Valentine leukocidin (PVL). The aim of this study is to show the association between recurrent episodes of skin and soft-tissue infections in members of the same family, previously healthly, and the presence of meticillin-susceptible S.aureus (MSSA) carrying PVL.

Methods: Because of recurrent skin and soft-tissue infections in the members of the same family, nasal swabs were collected in all members from March to September 2007. Antimicrobial susceptibility of S.aureus isolated strains was performed by disk-diffusion method. Genotype characterisation of PVL was made by coamplification of the genes lukS-PV and lukF-PV by PCR. Genomic DNA was extracted from cultures grown on agar plates, by a modified DNAeasy tissue kit (QIAGEN) procedure. Genes were identified as a 433 pb band in the agarose gel after electrophoreses of amplified product.

Results: Recurrent skin and soft-tissue infections were diagnosed in 7 out of 8 members of the same family (father, mother, son #1, granddaughter, son #2, partner of son #2 and roommate of son #2; partner of son #1 was not affected) from April 2005 to September 2007, with no known exposure to healthcare establishments. Abscesses were located in armpit, back, thigh, knee, leg and buttocks. S.aureus was isolated in nasal swabs in 5 of the members; nasal swabs were negative in 2 members, and there were not data from the eighth. S.aureus was also recovered from one abscess in the armpit. All S.aureus isolates presented the same phenotype, resistance to penicillin, and susceptibility to oxacillin, clindamycin, gentamicin, levofloxacin, rifampin, TMP-SMX and vancomycin. The genes lukS-PV and lukF-PV were identified in all 5 of the S.aureus isolated in nasal swabs. All abscesses, except two, need surgical debridement. Treatment was made with amoxicillin-clavulanic. Because recurrence of abscesses despite the treatment and nasal decolonisation, patients carrying MSSA are being treated 5 days a month with nasal mupirocin and foamy chlorhexidine. At 6 months of follow up no recurrence has being reported.

Conclusions: Interfamily transmission of MSSA PVL-carrying strain could be the cause of the recurrent skin and soft-tissue infections. The decolonisation of nasal carriers of MSSA and hygienic measures could clear up the problem of recurrence of infections.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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