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Panton-Valentine Leukozidin in chronischen Wunden

Ergebnisse einer klinischen Untersuchung bei 100 Patienten

Panton-Valentine leukocidin in patients with chronic wounds

Results from a clinical investigation in 100 patients

Der Hautarzt volume 65, pages 148–152 (2014)Cite this article

Zusammenfassung

Hintergrund

Das von S. aureus sezernierte Exotoxin Panton-Valentine Leukozidin (PVL) ist ein Virulenzfaktor, der zu besonders ausgeprägten Verläufen von Haut- und Weichteilinfektionen führen kann. Die Rolle von PVL für die Wundheilung ist bisher unklar. Wir haben daher in einer klinischen Studie die Nachweisrate von PVL-positiven S.-aureus-Isolaten bei Patienten mit chronischen Wunden untersucht.

Patienten und Methoden

Insgesamt wurden 100 Patienten mit chronischen Wunden der unteren Extremität eingeschlossen, bei denen im mikrobiologischen Abstrich S. aureus nachgewiesen wurde. Die Isolate wurden mittels PCR auf das Vorhandensein des PVL-Gens untersucht.

Ergebnisse

Insgesamt 94 % der Patienten hatten ein Ulcus cruris, 6 % ein Ulcus pedis. Es waren 65 % der Patienten weiblich. Ein PVL-positives S.-aureus-Isolat fand sich bei 2 Patienten – 1 Patient mit Methicillin-resistentem S. aureus (MRSA) und 1 Patient mit Methicillin-sensiblem S. aureus (MSSA).

Schlussfolgerung

Es zeigte sich eine Nachweisrate von PVL bei 2 % der S.-aureus-Isolate bei Patienten mit chronischen Wunden der unteren Extremitäten. Auch wenn die Bedeutung von PVL als Virulenzfaktor von S. aureus für die Wundheilung weiterhin unklar ist, sollte bei Patienten mit chronischen Wunden und Nachweis von PVL aufgrund der erhöhten Gefahr schwerwiegender Infektionen auf eine konsequente topische antimikrobielle Wundtherapie geachtet werden.

Abstract

Background

The toxin Panton-Valentine leukocidin (PVL) produced by S. aureus is known as a virulence factor that leads to severe infections of skin and soft tissue. However the effect of PVL on wound healing is not known yet. Therefore we examined the detection rate of PVL in patients with chronic wounds.

Patients and methods

The study included 100 patients with chronic wounds of the lower limb. We determined in all S. aureus isolates the presence of the PVL gene using a PCR technique.

Results

Altogether 94 % of the patients had a leg ulcer, while 6 % had a foot ulcer; 65 % were women. PVL was found in two patients. One of the strains was methicillin-resistant (MRSA) and the other was methicillin-sensitive (MSSA).

Conclusion

In our investigation there was detection rate for PVL of 2 % of all S. aureus isolates in patients with chronic wounds of the lower extremities. Although the role of PVL as a virulence factor of S. aureus in wound healing remains unclear, the detection of PVL should be taken as a cause for a consequent topical antimicrobial wound therapy because of the increased risk of serious infections.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Hammer, P.-M. Rath, J. Steinmann, M. Stoffels-Weindorf, J. Klode und J. Dissemond geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Affiliations

  1. Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    C. Hammer, M. Stoffels-Weindorf, J. Klode &  J. Dissemond

  2. Institut für Medizinische Mikrobiologie, Universitätsklinikum Essen, Essen, Deutschland

    P.-M. Rath & J. Steinmann

Authors
  1. C. Hammer
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  2. P.-M. Rath
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  3. J. Steinmann
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  4. M. Stoffels-Weindorf
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  5. J. Klode
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  6. J. Dissemond
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Correspondence to J. Dissemond.

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Hammer, C., Rath, PM., Steinmann, J. et al. Panton-Valentine Leukozidin in chronischen Wunden. Hautarzt 65, 148–152 (2014). https://doi.org/10.1007/s00105-013-2728-5

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  • DOI: https://doi.org/10.1007/s00105-013-2728-5

Schlüsselwörter

  • Weichteilinfektionen
  • Staphylococcus aureus
  • Methicillin
  • Wundtherapie
  • Wundheilung

Keywords

  • Soft tissue infections
  • Staphylococcus aureus
  • Methicillin
  • Wound therapy
  • Wound healing