Intrafamilial spread of Panton-Valentine-positive Staphylococcus aureus: a Spanish case

Abstract number: R2344

Gutiérrez-González I., Batista-Díaz N., Pérez-Roth E., Hernández-de la Torre M., Durán-Trujillo M., Delgado-Guerrero M., Méndez-Álvarez S.

Background: Panton-Valentine leukocidin is a toxin associated with severe cutaneous infections and highly necrotising pneumonia. This toxin acts as virulence factor in some Staphylococcus aureus strains wich may be transmissed by person-to-person contact.

Objectives: To describe a family outbreak of skin infections, including furuncules, abscesses and cellulitis by Staphylococcus aureus Panton-Valentine positive, during 24 months.

Methods: The family affected is composed by mother, father, six children between the ages 6–17 years who lived at the same home. The outbreak also affected a 75 years old woman who spent a lot of time with the family, and the first son girlfriend. Detailed information regarding the history of infections of each patient and related diagnostic results and treatment were collected from Family Physician, Dermatologist and Paediatrician who treated the cases.

Samples were collected from infected skin areas affected and some of the patients and their contacts were screened for nasal and pharyngeal S.aureus.

All the S.aureus isolates were identified by conventional and molecular methods.

PCR was made to detect genetic sequences encoding mecA gene, PVL, enterotoxins, exfoliative toxins, alfa, beta, gamma and delta hemolysins, LukE-LukD leukotoxin and different adhesins. Isolates were typed by pulsed field gel electrophoresis (PFGE) and later Multilocus SequenceTyping (MLST) to ascribe the detected PVL-positive clone.

Antimicrobial susceptibility was studied with AST-P536 Vitek test.

Results: The cases were: furuncules, cellulitis and abscesses of diverse location, doing a whole of sixteen episodes. Three needed surgical incision and drainage, and seven episodes needed hospitalisation.

All clinic samples yielded Staphylococcus aureus PVL positive in pure culture. All strains were only penicillin resistant (PRSA). Four nasal swabs and five pharyngeal swabs were positive for PRSA (PVL+/PVL-:4/5). None carryied meticillin resistant S.aureus. All clinical isolates showed the same phenotypic and genotypic profile.

All family received treatment with cloxacillin and topic mupirocin.

Conclusion: This is the first case of intrafamilial spread of Staphylococcus aureus Panton-Valentine positive described in Spain. It is of concern the possible mupirocin resistance development after repeated treatment. Finally, it could be of public health importance to control the spread of infection, because the outbreak may involve non hospitalised persons.

Session Details

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