E-ISSN 2231-170X | ISSN 2231-1696
 

Original Article 


Panton-Valentine Leukocidin gene positive methicillin resistant <i>Staphylococcus aureus</i>, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan.

Abstract
Methicillin resistant <i>Staphylococcus aureus</i> (MRSA) is an important pathogen that causes hospital acquired infections recorded in the intensive care unit (ICU). Most of the MRSA isolates carry mecA gene which is a molecular marker for Methicilin resistance. There are two types of MRSA , community acquired (C–MRSA) and hospital acquired (H-MRSA), both of these contain mecA gene. The Panton-Valentine Leukocidin (PVL) gene is normally present in C-MRSA infections which are now found to be widespread in hospital setting. Our objective was to assess the presence of PVL gene in mecA gene positive MRSA isolates from ICUs. This was a cross sectional study in ICUs of a tertiary care hospital over a period of 8 months (June 2013 to January 2014). Total of two hundred patients admitted in the ICUs who were suspected to have acquired infection 48 hours after admission were included in the study. By routine bacteriological examination and disc diffusion sensitivity testing with 30μg cefoxitin discs, MRSA strains were isolated. Polymerized chain reaction (PCR) was performed to detect mecA gene and PVL gene using specific primers. Cefoxitin disc diffusion screening showed 112 positive MRSA strains among which the mecA gene was detected in 104 strains and was absent in the remaining eight strains of total MRSA. Among the 104 mecA gene positive MRSA strains, 46 (44%) strains contained PVL gene. Our results indicate a higher prevalence of PVL-positive MRSA strains in the ICUs compared to many earlier studies. These strains were susceptible only to very few antibiotics and the empirical treatment options should be planned accordingly. Awareness of intensive care physicians and proper training of health care workers in the ICU could lower the magnitude of this problem.

Key words: C-MRSA, H-MRSA, ICU, mecA gene, PVL gene


 
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REFERENCES
1. Haddadin AS, Fappiano SA, Lipsett PA. Methicillin resistant Staphylococcus aureus (MRSA) in the intensive care unit. Postgrad Med J. 2002; 78(921):385-392. https://doi.org/10.1136/pmj.78.921.385 [Pubmed]    [PMC Free Fulltext]   
2. Thompson RL, Cabezudo I, Wenzel RP. Epidemiology of nosocomial infections caused by methicillin-resistant Staphylococcus aureus. Ann Intern Med. 1982; 97(3):309-317. https://doi.org/10.7326/0003-4819-97-3-309 [Pubmed]   
3. de Lencastre H, de Jonge BL, Matthews PR, Tomasz A. Molecular aspects of methicillin resistance in Staphylococcus aureus. J Antimicrob Chemother. 1994; 33(1):7-24. https://doi.org/10.1093/jac/33.1.7 [Pubmed]   
4. Badiou C, Dumitrescu O, George N, Forbes AR, Drougka E, Chan KS, Ramdani-Bouguessa N, Meugnier H, Bes M, Vandenesch F, Etienne J, Hsu LY, Tazir M, Spiliopoulou I, Nimmo GR, Hulten KG, Lina G. Rapid detection of Staphylococcus aureus Panton-Valentine leukocidin in clinical specimens by enzyme-linked immunosorbent assay and immunochromatographic tests. J Clin Microbiol. 2010; 48(4):1384-1390. https://doi.org/10.1128/JCM.02274-09 [Pubmed]    [PMC Free Fulltext]   
5. Ramdani-Bouguessa N, Bes M, Meugnier H, Forey F, Reverdy ME, Lina G, Vandenesch F, Tazir M, Etienne J. Detection of methicillin-resistant Staphylococcus aureus strains resistant to multiple antibiotics and carrying the Panton-Valentine leukocidin genes in an Algiers hospital. Antimicrob Agents Chemother. 2006; 50(3):1083-1085. https://doi.org/10.1128/AAC.50.3.1083-1085.2006 [Pubmed]    [PMC Free Fulltext]   
6. O'Brien FG, Pearman JW, Gracey M, Riley TV, Grubb WB. Community strain of methicillin-resistant Staphylococcus aureus involved in a hospital outbreak. J Clin Microbiol. 1999; 37(9):2858-2862.
7. Shashindran N, Nagasundaram N, Thappa DM, Sistla S. Can Panton Valentine Leukocidin gene and clindamycin susceptibility serve as predictors of community origin of mrsa from skin and soft tissue infections? J Clin Diagn Res. 2016; 10(1):DC01-4. [DOI via Crossref]    https://doi.org/10.7860/JCDR/2016/14531.7036
8. Zamani A, Sadeghian S, Ghaderkhani J, Alikhani MY, Najafirmosleh M, Goodarzi MT, Farahani HS, YousefiMashouf R. Detection of methicillin-resistance (mec-A) gene in Staphylococcus aureus strains by PCR and determination of antibiotic susceptibility. Annals of Microbiology. 2007; 57:273. https://doi.org/10.1007/BF03175219
9. Lina G, Piemont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, Vandenesch F, Etienne J. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999; 29(5):1128-1132. https://doi.org/10.1086/313461 [Pubmed]   
10. Chi CY, Lin CC, Liao IC, Yao YC, Shen FC, Liu CC, Lin CF. Panton-Valentine leukocidin facilitates the escape ofStaphylococcus aureus from human keratinocyte endosomes and induces apoptosis. J Infect Dis. 2014; 209(2):224-235. https://doi.org/10.1093/infdis/jit445 [Pubmed]   
11. Voyich JM, Otto M, Mathema B, Braughton KR, Whitney AR, Welty D, Long RD, Dorward DW, Gardner DJ, Lina G, Kreiswirth BN, DeLeo FR. Is Panton-Valentine leukocidin the major virulence determinant in community-associated methicillin-resistant Staphylococcus aureus disease? J Infect Dis. 2006; 194(12):1761-1770. https://doi.org/10.1086/509506 [Pubmed]   
12. D'Souza N, Rodrigues C, Mehta A. Molecular characterization of methicillin-resistant Staphylococcus aureus with emergence of epidemic clones of sequence type (ST) 22 and ST 772 in Mumbai, India. J Clin Microbiol. 2010; 48(5):1806-1811. https://doi.org/10.1128/JCM.01867-09 [Pubmed]    [PMC Free Fulltext]   
13. O'Brien FG, Lim TT, Chong FN, Coombs GW, Enright MC, Robinson DA, Monk A, Saïd-Salim B, Kreiswirth BN, Grubb WB. Diversity among community isolates of methicillin-resistant Staphylococcus aureus in Australia. J Clin Microbiol. 2004; 42(7):3185-3190. https://doi.org/10.1128/JCM.42.7.3185-3190.2004 [Pubmed]    [PMC Free Fulltext]   
14. Aires de Sousa M, Bartzavali C, Spiliopoulou I, Sanches IS, Crisóstomo MI, de Lencastre H. Two international methicillin-resistant Staphylococcus aureus clones endemic in a university hospital in Patras, Greece. J. Clin. Microbiol. 2003; 41(5):2027-2032.
15. Saiman L, O'Keefe M, Graham PL 3rd, Wu F, Saïd-Salim B, Kreiswirth B, LaSala A, Schlievert PM, Della-Latta P. Hospital transmission of community-acquired methicillinresistant Staphylococcus aureus among postpartum women. Clin. Infect. Dis 2003; 37(10):1313-1319.
16. Kikuchi K, Takahashi N, Piao C, Totsuka K, Nishida H, Uchiyama T. Molecular epidemiology of methicillinresistant Staphylococcus aureus strains causing neonatal toxic shock syndrome-like exanthematous disease in neonatal and perinatal wards. J. Clin. Microbiol. 2003; 41(7):3001-3006.

How to Cite this Article
Pubmed Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. J Med Allied Sci. 2016; 6(2): 56-60. doi:10.5455/jmas.222450


Web Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. https://jmas.in/?mno=222450 [Access: January 12, 2023]. doi:10.5455/jmas.222450


AMA (American Medical Association) Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. J Med Allied Sci. 2016; 6(2): 56-60. doi:10.5455/jmas.222450



Vancouver/ICMJE Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. J Med Allied Sci. (2016), [cited January 12, 2023]; 6(2): 56-60. doi:10.5455/jmas.222450



Harvard Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan (2016) Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. J Med Allied Sci, 6 (2), 56-60. doi:10.5455/jmas.222450



Turabian Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. 2016. Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. Journal of Medical and Allied Sciences, 6 (2), 56-60. doi:10.5455/jmas.222450



Chicago Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. "Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies." Journal of Medical and Allied Sciences 6 (2016), 56-60. doi:10.5455/jmas.222450



MLA (The Modern Language Association) Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan. "Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies." Journal of Medical and Allied Sciences 6.2 (2016), 56-60. Print. doi:10.5455/jmas.222450



APA (American Psychological Association) Style

Mowna Karthik, Prabhu Thilaak, Indra Priyadharsini, Senthil Marappan (2016) Panton-Valentine Leukocidin gene positive methicillin resistant Staphylococcus aureus, the community strains causing infections in intensive care unit - High risk of outbreak and preventing strategies. Journal of Medical and Allied Sciences, 6 (2), 56-60. doi:10.5455/jmas.222450