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Journal of Clinical Microbiology, May 2005, p. 2384-2390, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2384-2390.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Staphylococcus aureus Isolates Carrying Panton-Valentine Leucocidin Genes in England and Wales: Frequency, Characterization, and Association with Clinical Disease

A. Holmes,* M. Ganner, S. McGuane, T. L. Pitt, B. D. Cookson, and A. M. Kearns

Laboratory of HealthCare Associated Infection, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London, NW9 5HT, United Kingdom

Received 15 April 2004/ Returned for modification 20 August 2004/ Accepted 13 January 2005

Staphylococcus aureus isolates carrying the genes that encode for Panton-Valentine leucocidin (PVL), a highly potent toxin, have been responsible for recent outbreaks of severe invasive disease in previously healthy children and adults in the United States of America and Europe. To determine the frequency of PVL-positive isolates sent to the Staphylococcus Reference Unit (United Kingdom) for epidemiological purposes, we tested 515 isolates of S. aureus, and 8 (1.6%) were positive for the PVL locus. A further 470 isolates were selected to explore the association of PVL-positive S. aureus with clinical disease. Of these, 23 (4.9%) were PVL positive and most were associated with skin and soft tissue infections (especially abscesses). The PVL genes were also detected in isolates responsible for community-acquired pneumonia, burn infections, bacteremia, and scalded skin syndrome. Genotyping by pulsed-field gel electrophoresis and multilocus sequence typing revealed that the PVL-positive isolates were from diverse genetic backgrounds, although one prevalent clone of 12 geographically dispersed methicillin-resistant S. aureus (MRSA) isolates was identified (ST80). All 12 isolates were stapylococcal cassette chromosome mec type IVc, had an agr3 allele, and shared a common toxin gene profile (sea-see, seg-sej, eta, etb, and tst negative but etd positive). ST80 strains with similar genetic characteristics have been responsible for community-acquired infections in France and Switzerland. The remaining PVL-positive isolates were mostly methicillin-sensitive S. aureus and belonged to 12 different sequence types, including ST22 and ST30, which are closely related to the most prevalent MRSA clones in United Kingdom hospitals, EMRSA-15 and EMRSA-16, respectively.

* Corresponding author. Mailing address: Laboratory of Healthcare-Associated Infection, Centre for Infections, 61 Colindale Avenue, London, NW9 5HT, United Kingdom. Phone: 44 208 200 4400. Fax: 44 208 200 7449. E-mail: anne.holmes{at}hpa.org.uk.

Journal of Clinical Microbiology, May 2005, p. 2384-2390, Vol. 43, No. 5
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.5.2384-2390.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



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