Host Determinants for the Spread of Panton-Valentine Leukocidin-Positive Staphylococcus aureus in Sub-Saharan Africa

The Panton-Valentine leukocidin (PVL) of Staphylococcus aureus can be associated with severe and recurrent skin and soft tissue infections. The prevalence of PVL is particularly high in sub-Saharan Africa. We assessed, in a multicenter cross-sectional study, whether host-related factors could explain this high PVL prevalence. We found higher serum anti-PVL-IgG levels in participants from Africa (Gabon, Nigeria, Congo) as compared with Europe (Germany). PVL-induced cytolysis of neutrophils was higher in Africans and linked to a polymorphism of the C5a receptor (rs11880097 T/G), the cellular target of the lukS subunit of PVL. The inflammasome response of monocytes to PVL is shifted toward IL-1β and IL-8 in Africans, while Europeans have a stronger IL-18 response. Thus, African neutrophils are more susceptible to PVL, and monocytes exert a stronger Th1 immune response, eventually increasing the risk of tissue damage (eg, due to a stronger recruitment of neutrophils via IL-1β and IL-8) in PVL-positive S aureus skin and soft tissue infections in Africans.