Epidemiology of Panton-Valentine Leukocidin harbouring Staphylococcus aureus in cutaneous infections from Iran: a systematic review and meta-analysis.

Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus has been associated with severity of skin infections and pathology that suggest a major role in pathogenicity. The present study aimed to determine the overall prevalence of PVL harbouring S. aureus isolates from cutaneous infections in Iran. A systematic search was performed by using Medline electronic databases (PubMed) from the papers published by Iranian authors to the end of March 2017. Ten publications which met our inclusion criteria were then selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of PVL in cutaneous infections was estimated at 27.9% (95% CI: 17.9-40.6). The range of PVL positivity among S. aureus isolates obtained from cutaneous infections was from 7.4% to 55.6%. In summary, despite the emergence of multiple-drug resistant strains, it seems that the overall prevalence of PVL carrying S. aureus in Iran remains steady regardless of methicillin resistance. However, further research is required to elucidate the interplay between the risk of invasive disease and PVL, especially in Iran.