Community-acquired methicillin-resistant Stapylococcus aureus carrying the Panton-Valentine genes in invasive infections in Algiers
Abstract number: P1029
Ramdani-Bouguessa N., Antri K., Ziane H., Djennane F., Bes M., Lina G., Tazir M., Etienne J.
Objectives: Community acquired methicillin-resistant S. aureus (C-MRSA) are spreading worldwide. They are responsible for lifethreatning infections such as, necrotizing pneumonia and osteomyelitis. Panton-Valentine leukocidin (PVL), a virulent factor, plays a role in the pathophysiology of these infections. In Algeria, a high prevalence of CA-MRSA-PVL+ has already been reported, however, the frequency of C-MRSA-PVL+ in invasive infections is underestimated. The aim of this study is to evaluate the frequency of invasive infections due to CA-MRSA-PVL+.
Methods: A prospective study was conducted from january 2008 to october 2009. S. aureus was identified by coagulase and latex agglutination. Antibiotic susceptibilities were determined by disk diffusion according to CLSI recommendations. S. aureus identification was based on colony morphology, microscopic examination, results of coagulase rabbit plasma and Staphyslide agglutination tests (bioMérieux). The detection of mecA gene, PVL-genes (LukS-PV, lukF-PV) and accessory gene regulator alleles (agr types 1 to 4) was performed by multiplex PCR for 45 of the 51 invasive S. aureus isolates.
Results: A total of 695 S. aureus strains has been collected, 356 (51%) were responsible for community-acquired infections. Of them, 57 were responsible for invasive infections: pneumonia (n = 26), bone infections (n = 19), bacteraemia (n = 9), central nervous infection (n = 3), endocarditis (n = 2) and peritonitis (n = 1). Thirty-two (56%) of these infections were from children. C-MRSA infections were detected in 18 patients. PVL-genes were detected in 20 (44.4%) isolates: bone infections (n = 10), pneumonia (n = 7), bacteraemia (n = 1) and 2 endocarditis. These isolates harboured the following profiles: agr3,mecA+,pvl+ (n = 13), agr3,mecA-,pvl+ (n = 4) and agr4,mecA-,pvl+ (n = 3). Three patients died, all had C-MRSA-PVL+ infections, two pneumonia, one bacteraemia and one endocarditis.
Conclusions: A high prevalence of C-MRSA-PVL+ severe infections is observed, physician should reconsider the empiric antibiotic treatment of these infections.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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