Department of Infectious Diseases, Kyorin University School of Medicine.
Department of Dermatology, Kyorin University School of Medicine.
Jpn J Infect Dis. 2020 Jan 23;73(1):72-75. doi: 10.7883/yoken.JJID.2019.162. Epub 2019 Oct 31.
Panton-Valentine leukocidin (PVL) is a causative agent of lethal necrotizing pneumonia and is associated with epidemic strains of community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA). PVL-producing strains have rarely been isolated in Japan. However, PVL-positive CA-MRSA has been isolated much more frequently in recent years. To investigate the relevance of pvl genes (lukS/F-PV) and clinical traits in epidemic S. aureus strains, we genotyped four PVL-positive CA-MRSA strains isolated from patients with skin and soft tissue infections and measured their susceptibility to antibiotics. Three of the isolates matched the genotype of the USA300 clone, which has predominantly been isolated in the USA. The remaining strain matched the ST217 genotype, and its spa type was identical to that of PVL-positive strains previously reported in India and China. Abscess drainage was necessary in all cases, and deep cutaneous ulcers were formed in three out of four cases regardless of the genotype. The ST217 genotype strain was resistant to clindamycin, in addition to quinolones, macrolides, and aminoglycosides. Thus, diagnostic determination of lukS/F-PV should be used as a guide for selecting the treatment regimen.
Panton-Valentine 白细胞素 (PVL) 是一种致命性坏死性肺炎的病原体，与社区获得性（CA）耐甲氧西林金黄色葡萄球菌（MRSA）的流行株有关。PVL 产生株在日本很少被分离出来。然而，近年来 PVL 阳性 CA-MRSA 的分离率却显著增加。为了研究 pvl 基因（lukS/F-PV）与流行的金黄色葡萄球菌株的临床特征之间的相关性，我们对 4 株从皮肤和软组织感染患者中分离出的 PVL 阳性 CA-MRSA 菌株进行了基因分型，并检测了它们对抗生素的敏感性。其中 3 株与 USA300 克隆的基因型相匹配，该克隆主要在美国分离。另一株与 ST217 基因型相匹配，其 spa 型与之前在印度和中国报道的 PVL 阳性株相同。所有病例均需要进行脓肿引流，无论基因型如何，4 例中有 3 例均形成深部皮肤溃疡。ST217 基因型菌株除了对喹诺酮类、大环内酯类和氨基糖苷类药物耐药外，还对克林霉素耐药。因此，lukS/F-PV 的诊断检测应作为选择治疗方案的指导。
