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Published on: February 23, 2014
Recurrent mucocutaneous infections caused by PVL-positive Staphylococcus aureus strains: a challenge in clinical
Galina Balakirski1, Gunnar Hischebeth2, Julia Altengarten1
1Department of Dermatology and Allergology, University Hospital Bonn, Bonn, Germany.
Background:
Recurrent mucocutaneous infections caused by PVL-positive Staphylococcus (S.) aureus strains represent an increasing problem in Germany. Although there have been several outbreaks at day care centers and in urban communities in recent years, there are currently no diagnostic algorithms or treatment recommendations for these particular infections in Germany.
Methods:
We performed a literature search in the PubMed/MEDLINE database with the goal of developing an algorithm for diagnosis and treatment of these infections. National and international recommendations were also considered.
Results:
Panton-Valentine leukocidin (PVL) is a pore-forming protein produced by certain S. aureus strains. Both methicillin-susceptible (MSSA) and methicillin-resistant S. aureus (MRSA) strains may carry the lukS-lukF gene responsible for PVL production. The clinical presentation of infections caused by PVL-positive S. aureus ranges from isolated recurrent abscesses to extensive furunculosis. Despite adequate treatment of primary infections, approximately 40 % of patients develop recurrent disease. The choice of treatment regimen is guided by the clinical presentation of the infection. In addition, some scientific literature recommends bacteriological screening of patients and their contacts, followed by decolonization of affected individuals.
Conclusions:
The present article focuses on the pathogenesis and risk factors of recurrent mucocutaneous infections caused by PVL-positive S. aureus strains and proposes a diagnostic and therapeutic algorithm for optimal patient care.
Insights
Recurrent skin infections from Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus are rising. This study proposes a diagnostic and treatment algorithm for PVL-positive S. aureus infections, addressing the lack of current guidelines in Germany.
Area of Science:
- Infectious Diseases
- Microbiology
- Dermatology
Background:
- Recurrent mucocutaneous infections caused by Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus are an increasing concern.
- Outbreaks have occurred in German day care centers and communities, highlighting a gap in diagnostic and treatment guidelines.
Purpose of the Study:
- To develop a diagnostic and treatment algorithm for PVL-positive S. aureus infections.
- To address the growing problem of recurrent mucocutaneous infections caused by these strains.
Main Methods:
- Conducted a literature search in the PubMed/MEDLINE database.
- Incorporated national and international treatment recommendations.
- Focused on pathogenesis, risk factors, and proposed a clinical algorithm.
Main Results:
- Panton-Valentine leukocidin (PVL) is a toxin produced by S. aureus strains (both MSSA and MRSA).
- Infections range from abscesses to furunculosis, with ~40% recurrence despite treatment.
- Treatment choice depends on clinical presentation; screening and decolonization are suggested.
Conclusions:
- PVL-positive S. aureus poses a significant challenge due to recurrent infections.
- A proposed diagnostic and therapeutic algorithm aims to optimize patient care for these infections.
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