Clinical isolates of Pantone-Valentine leucocidin- and gamma-haemolysin-producing Staphylococcus aureus: prevalence and association with clinical infections.

Pantone-Valentine leucocidin (PVL) and gAMMA-haemolysin (Hlg) are members of the synergohymenotropic toxin family produced by Staphylococcus aureus and encoded by pvl and hlg genes, respectively. Many reports describe an association between PVL toxin and necrotic lesions involving skin and mucosa. The aim of this study was to determine the prevalence of S. aureus strains carrying pvl and hlg genes and to investigate a possible relationship between pvl- and hlg-positive S. aureus with specific clinical presentations. Between January 2005 and July 2007, a total of 143 S. aureus strains including 58 meticillin-resistant S. aureus (MRSA) and 85 meticillin-susceptible S. aureus were screened for pvl and hlg genes by multiplex polymerase chain reaction. These strains were isolated from 141 patients for whom demographic and clinical data were recorded. Thirty-one (21.7%) and 77 (53.7%) isolates were positive for pvl and hlg genes, respectively. Twenty-one (67.7%) pvl-positive strains were MRSA (P = 0.001). Among pvl-positive strains, 16 (51.6%) were community-acquired. There was a strong association between pvl genes and skin and soft tissue infections, especially abscesses (60% of strains; P = 0.008) and furunculosis (55.5% of strains; P = 0.036). Our findings confirmed the association between pvl-positive strains, cutaneous infections and meticillin resistance in S. aureus.