Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Hospital Universiti Sains Malaysia, Health Campus, USM, 16150 Kubang Kerian, Kelantan, Malaysia.
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia; Acarology Unit, Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, National Institutes of Health Complex, Bandar Setia Alam, 40170 Shah Alam, Selangor, Malaysia.
J Infect Public Health. 2020 Oct;13(10):1508-1512. doi: 10.1016/j.jiph.2020.06.018. Epub 2020 Jul 9.
Panton-Valentine Leukocidin (PVL), is one of the virulence gene expressed by Methicillin Resistant Staphylococcus aureus (MRSA) and is known to be associated with severe form of community acquired MRSA infection. The aim of this study is to investigate its prevalence in our setting and patient's clinical outcome.
A cross sectional study involve retrospective record review were done involving 90 MRSA positive isolates between November 2016 and October 2017. Multiplex PCR was performed to detect femA, mecA and PVL genes. Clinical presentation and outcomes of patients were reviewed and presented as descriptive analysis.
All of the 90 MRSA isolates included in this study were positive for femA and mecA genes following PCR. PVL gene was detected in 20% (n = 18) of the isolates of which 61.1% (n = 11) were community acquired infections and 38.8% (n = 7) were hospital acquired. Case distribution from community acquired infections include patients with skin and soft tissue infections (33.3%, n = 6), infected diabetic foot ulcers (16.7%, n = 3), and one patient each (5.5%, n = 1) for community acquired pneumonia and meningitis. Half of the PVL positive MRSA cases (50%, n = 9) were having sepsis and four of them succumbed to death due to severe infection.
This study shows a high prevalence of PVL positive MRSA infection in our population. Skin and soft tissue infections accounting for the major sources. In addition, the presence of the PVL gene is associated with increased risk for developing sepsis.
金黄色葡萄球菌（MRSA）表达的毒力基因之一是潘顿-瓦伦丁白细胞毒素（PVL），已知与社区获得性 MRSA 感染的严重形式有关。本研究旨在调查其在本地区的流行情况和患者的临床结局。
这是一项回顾性病例研究，涉及 2016 年 11 月至 2017 年 10 月期间 90 例 MRSA 阳性分离株。采用多重 PCR 检测 femA、mecA 和 PVL 基因。回顾性分析患者的临床表现和结局，并进行描述性分析。
本研究中所有 90 例 MRSA 分离株经 PCR 检测均为 femA 和 mecA 基因阳性。PVL 基因在 20%（n=18）的分离株中被检测到，其中 61.1%（n=11）为社区获得性感染，38.8%（n=7）为医院获得性感染。社区获得性感染的病例分布包括皮肤和软组织感染患者（33.3%，n=6）、感染性糖尿病足溃疡患者（16.7%，n=3）、社区获得性肺炎和脑膜炎各 1 例（5.5%，n=1）。PVL 阳性 MRSA 病例中有一半（50%，n=9）出现败血症，其中 4 例因严重感染死亡。
本研究表明，PVL 阳性 MRSA 感染在本地区流行率较高。皮肤和软组织感染是主要来源。此外，PVL 基因的存在与发生败血症的风险增加相关。
