Department of Dermatology, University of the Ryukyus, Okinawa, Japan.
J Dermatol. 2013 Jan;40(1):34-8. doi: 10.1111/j.1346-8138.2012.01569.x. Epub 2012 Nov 1.
Panton-Valentine leukocidin (PVL) is a pore-forming cytotoxin that is produced by Staphylococcus aureus closely associated with skin and soft-tissue infections (SSTI). PVL-positive S. aureus strains have been identified worldwide, including in the USA; however, few studies have reported the presence of these strains in Japan. In this study, we prospectively investigated the prevalence of PVL in S. aureus strains from outpatients presenting with SSTI in Okinawa and characterized the PVL-positive S. aureus strains by polymerase chain reaction (PCR) and multilocus sequence typing (MLST). From 2008-2010, 499 clinical samples were obtained from 497 people. S. aureus was identified in 274 samples, and 36% (99 of 274) were methicillin-resistant S. aureus (MRSA). Seventeen (6.2%) PVL-positive S. aureus strains were detected by PCR, and 12 of the 17 PVL-positive strains were MRSA. Most PVL-positive S. aureus caused furuncles or carbuncles. Nine of the 17 PVL-positive isolates had an ST8 MRSA genotype and most harbored SCCmec type IVa and the arcA gene of the arginine catabolic mobile element, which is identical to the USA300 clone prevalent in the USA. PVL-positive S. aureus strains were more likely to be resistant to erythromycin (65%) and levofloxacin (53%). PVL-positive S. aureus strains have emerged and are spreading as a causative pathogen for SSTI in Okinawa.
葡萄球菌杀白细胞素（PVL）是一种由金黄色葡萄球菌产生的孔形成细胞毒素，与皮肤和软组织感染（SSTI）密切相关。PVL 阳性的金黄色葡萄球菌菌株已在全球范围内被发现，包括在美国；然而，在日本，很少有研究报道这些菌株的存在。在这项研究中，我们前瞻性地调查了冲绳门诊 SSTI 患者金黄色葡萄球菌中 PVL 的流行情况，并通过聚合酶链反应（PCR）和多位点序列分型（MLST）对 PVL 阳性金黄色葡萄球菌菌株进行了特征分析。2008-2010 年，从 497 名患者中获得了 499 份临床样本。在 274 份样本中鉴定出金黄色葡萄球菌，其中 36%（274 份中的 99 份）为耐甲氧西林金黄色葡萄球菌（MRSA）。通过 PCR 检测到 17 株（6.2%）PVL 阳性金黄色葡萄球菌菌株，其中 12 株为 MRSA。大多数 PVL 阳性金黄色葡萄球菌引起疖或痈。17 株 PVL 阳性分离株中有 9 株为 ST8 MRSA 基因型，大多数携带 SCCmec 型 IVa 和精氨酸分解移动元件的 arcA 基因，与美国流行的 USA300 克隆相同。PVL 阳性金黄色葡萄球菌菌株更可能对红霉素（65%）和左氧氟沙星（53%）耐药。PVL 阳性金黄色葡萄球菌菌株已出现并传播，成为冲绳 SSTI 的致病病原体。
