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Case Report: Necrotizing fasciitis caused by Staphylococcus aureus positive for a new sequence variant of exfoliative

Artur J Sabat1, Marjan Wouthuyzen-Bakker1, Angelique Rondags2

  • 1Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Frontiers in Genetics
|October 3, 2022
PubMed

Insights

Necrotizing fasciitis (NF) is a severe infection caused by Staphylococcus aureus. This study identified novel virulence genes, including exfoliative toxin ETE2 and Panton-Valentine leukocidin (PVL), in an MSSA strain linked to NF, suggesting a role in pathogenesis.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Necrotizing fasciitis (NF) caused by Staphylococcus aureus (S. aureus) is a rare but severe infection with high mortality.
  • Identifying virulence factors is crucial for understanding S. aureus pathogenesis and developing targeted therapies.

Observation:

  • A methicillin-susceptible S. aureus (MSSA) isolate (UMCG579) from a monomicrobial NF case was sequenced.
  • The genome revealed genes for Panton-Valentine leukocidin (PVL) and a novel exfoliative toxin variant, ete2 (ETE2).
  • The ete2 gene was found exclusively in MLST CC152 isolates, primarily from human sources, and located on a genomic island.

Findings:

  • The MSSA UMCG579 genome lacks plasmids but contains genes for pore-forming toxins like PVL.
  • A new exfoliative toxin variant, ete2, was identified and associated with human isolates of MLST CC152.
  • Comparative genomics placed the ete2 gene on a specific genomic island.

Implications:

  • The combination of ETE2 and PVL toxins may enhance S. aureus virulence in NF.
  • Understanding these specific virulence mechanisms is vital for developing anti-virulence therapies.
  • Further research is needed to determine the precise role of ETE variants in S. aureus-associated NF.
Keywords:
ETEETE2PVLStaphylococcus aureusnecrotizing fasciitis

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