Prevalence of Panton-Valentine leukocidin genes in community-associated methicillin-resistant Staphylococcus aureus in the District of Pomoravlje
Abstract
Background/Aim. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains appear to have rapidly disseminated among population in the community without established risk factors for MRSA worldwide. Panton–Valentine leukocidin (PVL) is a cytolytic toxin, encoded by the lukF-PV and lukF-PV genes. PVL may be the key toxin responsible for enhanced virulence of CA-MRSA. The aim of this study was to detect the genes encoding PVL in CA-MRSA isolates from healthy people from the District of Pomoravlje. Methods. We took throat and nose swabs from healthy, employed persons with mandatory sanitary examinations and analyzed the presence of MRSA, between January 2011 and December 2012 in the District of Pomoravlje. Susceptibility of isolated strains to cefoxitin was investigated by using disc diffusion according to the recommendation of CLSI (Clinical Laboratory Standard Institute), and by E test. The presence of penicillin–binding protein 2a (PBP2a) in Staphylococci was detected using latex agglutination Slidex®MRSA Detection test. The gold standard, polymerase chain reaction (PCR) assay, was used for detection of mecA gene and PVL gene, and typing of SCCmec region. Results. Our investigation showed that staphylococcal carrier state was present in 2.58% of 52,910 throat and nasal swabs, and in 50 of them (3.67%) MRSA was isolated. Among these MRSA, 2 (4%) isolates were PVL-positive. Conclusion. The prevalence of CA-MRSA and the presence of PVL gene among healthy, employed population in the District of Pomoravlje were low. The values obtained in this study show that, our region is not significantly different from the other parts of our country, nor from the other European countries.
References
Archer GL. Staphylococcus aureus: a well-armed pathogen. Clin Infect Dis 1998; 26(5): 1179−81.
Jones ME, Mayfield DC, Thornsberry C, Karlowsky JA, Sahm DF, Peterson D. Prevalence of oxacillin resistance in Staphylo-coccus aureus among inpatients and outpatients in the United States during 2000. Antimicrob Agents Chemother 2002; 46(9): 3104−5.
Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, et al. Methicillin-resistant S. aureus Infections among Patients in the emergency department. N Eng J Med 2006; 355(7): 666−74.
Paez A, Skiest D. Methicillin-resistant Staphylococcus aureus: From the hospital to the community. Curr Infect Dis Rep 2008; 10(1): 14−21.
Lazarevic V, Beaume M, Corvaglia A, Hernandez D, Schrenzel J, François P. Epidemiology and virulence insights from MRSA and MSSA genome analysis. Futur Microbiol 2011; 6(5): 513−32.
Gordon R, Lowy F. Pathogenesis of methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis 2008; 46(Suppl 5): S350−9.
Van de Velde H. Etude sur le mécanisme de la virulence du staphylocoque pyogène. La Cellule 1894; 10: 401-10.
Wright J. Staphylococcal leucocidin (Neisser-Wechsberg type) and antileucocidin. Lancet 1936; 227(5879): 1002−5.
Vandenesch F, Naimi T, Enright MC, Lina G, Nimmo GR, Heffernan H, et al. Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg Infect Dis 2003; 9(8): 978−84.
Brown ML, O'Hara FP, Close NM, Mera RM, Miller LA, Suaya JA, Amrine-Madsen H. Prevalence and Sequence Variation of Panton-Valentine Leukocidin in Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Strains in the United States. J Clin Microbiol 2011; 50(1): 86−90.
Carleton HA, Diep BA, Charlebois ED, Sensabaugh GF, Perdreau-Remington F.Community-adapted methicillin-resistant Staphy-lococcus aureus (MRSA): population dynamics of an expand-ing community reservoir of MRSA. J Infect Dis 2004; 190(10): 1730−8.
Hultén KG, Kaplan SL, Lamberth LB, Slimp K, Hammerman WA, Carrillo-Marquez M, et al. Hospital-acquired Staphylococcus aureus infections at Texas Children's Hospital, 2001-2007. Infect Control Hosp Epidemiol 2010; 31(2): 183−90.
Shukla SK, Stemper ME, Ramaswamy SV, Conradt JM, Reich R, Graviss EA, et al. Molecular characteristics of nosocomial and Native American community-associated methicillin-resistant Staphylococcus aureus clones from rural Wisconsin. J Clin Mi-crobiol 2004; 42(8): 3752−7.
O'Brien FG, Lim TT, Chong FN, Coombs GW, Enright MC, Robinson DA, et al. Diversity among community isolates of methicillin-resistant Staphylococcus aureus in Australia. J Clin Microbiol 2004; 42(7): 3185−90.
Clinical Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Approved standard 11th ed.. CLSI document M02-A11. Wayne, PA: Clinical and Laboratory Standards Institute; 2013.
Centers for Disease Control and Prevention. Community associated MRSA information for clinicians. Infection control topics. [cited 2005 February 3]. Available from: http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca_clinicians.html#4.
Oliveira DC, de Lencastre H. Multiplex PCR strategy for rapid identification of structural types and variants of the mec ele-ment in methicillin-resistant Staphylococcus aureus. Antimi-crob Agents Chemother 2002; 46(7): 2155−61.
Lina G, Piémont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, et al. Involvement of Panton-Valentine leuko-cidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 1999; 29(5): 1128−32.
Milheiriço C, Oliveira DC, de Lencastre H. Update to the multiplex PCR strategy for assignment of mec element types in Staphylococcus aureus. Antimicrob Agents Chemother 2007; 51(9): 3374−7.
Obradović B, Kovačević L, Miloradović-Aćimović M, Purtić-Kljajić D, Relić T. Prevalence of methicellin-resistant strains of Staphylococcus aureus in the healthy Belgrade population. Zdravstvena zaštita 2009; 38(2): 27−31. (Serbian)
den Heijer CD, van Bijnen EM, Paget WJ, Pringle M, Goossens H, Bruggeman CA, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study. Lancet In-fect Dis 2013; 13(5): 409−15.
von Eiff C, Becker K, Machka K, Stammer H, Peters G. Nasal car-riage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 2001; 344(1): 11−6.
Ćirković I, Đukić S, Vuković D, Stevanović G, Švabić -Vlahović M, Stepanović S. Nasal carriage of methicillin-resistant Staphylo-coccus aureus among medical students of Belgrade University. Srp Arh Celok Lek 2013; 141(5−6): 349−53. (Serbian)
Diep BA, Gill SR, Chang RF, Phan TH, Chen JH, Davidson MG, et al. Complete genome sequence of USA300, an epidemic clone of community-acquired methicillin-resistant Staphylo-coccus aureus. Lancet 2006; 367(9512): 731−9.
Petrović Jeremić LJ. Sensitivity of methicillin-resistent Strephylo-coccus anreus in hospital and non-hospital settings to the ather groups of antibiotics. PONS 2009; 16: 18−25. (Serbian)
Krziwanek K, Luger C, Sammer B, Stumvoll S, Stammler M, Metz-Gercek S, Mittermayer H. PVL-positive MRSA in Austria. Eur J Clin Micribiol Infect Dis 2007; 26(12): 931−5.
Gouveia C, Friães A, Neves CM, Melo J, Ramirez CM. MRSA and PVL positive Staphylococcus aureus are rarely found in community-acquired osteoarticular infections in children in Portugal, a country with high MRSA Prevalence. Online Int J Micr Res 2013; 1(2): 20−4.
Zhang K, McClure J, Elsayed S, Tan J, Conly JM. Coexistence of Panton-Valentine leukocidin-positive and -negative communi-ty-associated methicillin-resistant Staphylococcus aureus USA400 sibling strains in a large Canadian health-care region. J Infect Dis 2008; 197(2): 195−204.
Cirkovic I, Sorum M, Radenkovic D, Vlahovic MS, Larsen AR. National surveillance reveals findings of Panton-Valentine leukocidin positive meticillin-resistant Staphylococcus aureus in Serbia. J Med Microbiol 2012; 62: 342−4.