Multiple Abszesse bei immunkompetenten Patienten durch Panton-Valentin-Leukozidin-positiven Staphylococcus aureus

Multiple abscesses in immunocompetent patients caused by Panton-Valentine leukocidin positive Staphylococcus aureus

Zusammenfassung

Wir berichten hier über den Fall von Patienten mit multiplen Abszessen durch Panton-Valentin-Leukozidin- (PVL-)positiven Staphylococcus aureus. Die Produktion dieses Zytotoxins stellt mutmaßlich einen entscheidenden Virulenzfaktor dar. Typische Erkrankungen durch diese Erreger sind rezidivierende Abszesse der Haut. Selten treten nekrotisierende Pneumonien mit hoher Letalitätsrate auf. Auch Methicillin-resistente PVL-positive Stämme sind in Deutschland bereits beschrieben worden. Erst die konsequente Anwendung geeigneter Hygienemaßnahmen zusammen mit einer adäquaten antimikrobiellen Therapie führte zur Sanierung. Hautärzte sollten über dieses Krankheitsbild und die erforderlichen Maßnahmen informiert sein.

Abstract

We report cases of immunocompetent patients showing multiple abscesses by a Panton-Valentine leukocidin (PVL) positive Staphylococcus aureus. PVL is considered to be an important virulence factor. The most common manifestations by this pathogen are recurrent or multiple abscesses of the skin. Seldom necrotizing pneumonia with high mortality occurs. Even methicillin-resistant PVL positive isolates have been identified in Germany. Only appropriate infection control measures in combination with antimicrobial therapy resulted in successful eradication of this pathogen. Dermatologists should be informed about this specific type of infection and about the appropriate infection control measures.

This is a preview of subscription content, access via your institution.

Abb. 1
Abb. 2

Literatur

  1. 1.

    Gillet Y, Issartel B, Vanhems P et al. (2002) Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients. Lancet 359: 753–759

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Issartel B, Tristan A, Lechevallier S et al. (2005) Frequent carriage of Panton-Valentine leucocidin genes by Staphylococcus aureus isolates from surgically drained abscesses. J Clin Microbiol 43: 3203–3207

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Kaneko J, Kimura T, Narita S et al. (1998) Complete nucleotide sequence and molecular characterization of the temperate staphylococcal bacteriophage phiPVL carrying Panton-Valentine leukocidin genes. Gene 215: 57–67

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Lina G, Piemont Y, Godail-Gamot F et al. (1999) Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis 29: 1128–1132

    PubMed  Article  CAS  Google Scholar 

  5. 5.

    Linde H, Wagenlehner F, Strommenger B et al. (2005) Healthcare-associated outbreaks and community-acquired infections due to MRSA carrying the Panton-Valentine leucocidin gene in southeastern Germany. Eur J Clin Microbiol Infect Dis 24: 419–422

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Martinez-Aguilar G, Avalos-Mishaan A, Hulten K et al. (2004) Community-acquired, methicillin-resistant and methicillin-susceptible Staphylococcus aureus musculoskeletal infections in children. Pediatr Infect Dis J 23: 701–706

    PubMed  Article  Google Scholar 

  7. 7.

    Raab U, Kahlau D, Wagenlehner F et al. (2006) Prevalence of and risk factors for carriage of Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus among residents and staff of a German nursing home. Infect Control Hosp Epidemiol 27: 208–211

    PubMed  Article  Google Scholar 

  8. 8.

    Rankin S, Roberts S, O’Shea K et al. (2005) Panton valentine leukocidin (PVL) toxin positive MRSA strains isolated from companion animals. Vet Microbiol 108: 145–148

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Wiese-Posselt M, Hamouda O (2005) Ausbruch von Furunkeln durch lunkS-lukF-positive Staphylococcus aureus in einem Dorf in Brandenburg, 2002–2004. Epidemiol Bull 10: 79–83

    Google Scholar 

  10. 10.

    Witte W, Cuny C, Strommenger B et al. (2004) Emergence of a new community acquired MRSA strain in Germany. Euro Surveill 9: 16–18

    PubMed  CAS  Google Scholar 

  11. 11.

    Witte W, Wiese-Posselt M, Jappe U (2005) Community-based MRSA. A new challenge for dermatology. Hautarzt 56: 731–738

    PubMed  Article  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Dr. R.-P. Vonberg.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Vonberg, RP., Sedlacek, L., Chaberny, I. et al. Multiple Abszesse bei immunkompetenten Patienten durch Panton-Valentin-Leukozidin-positiven Staphylococcus aureus . Hautarzt 59, 319–322 (2008). https://doi.org/10.1007/s00105-007-1374-1

Download citation

Schlüsselwörter

  • PVL
  • S. aureus
  • Abszess
  • Pneumonie
  • Hygienemaßnahmen

Keywords

  • PVL
  • S. aureus
  • Abscess
  • Pneumonia
  • Infection control measures