Skin and soft tissue infections due to Panton-Valentine leukocidin producing Staphylococcus aureus

Objective. - The authors had for aim to describe the epidemiological and clinical characteristics, and the treatment of patients presenting with skin and soft tissue infections clue to Panton Valentine leukocidin (PVL) producing Staphylococcus aureus in the Nord-Pas-de-Calais (NPDC) region, North of France. Methods. - We included patients presenting with PVL producing S. aureus infection from seven hospitals in the NPDC region, between February 2004 and April 2008. We retrospectively collected patient data using a standardized questionnaire. The features of patients presenting with skin and soft tissue were then analyzed. Results. - PVL producing S. aureus was isolated from 64 patients. Fifty-four patients presented with skin and soft tissue infections. The mean age of patients was 23.8 years (63% male patients). The mean number of persons living with the infected patient was 4.5 (vs. 2.5 in NPDC). The lesions were abscesses with inflammatory signs in 64.8% of the cases (20% were necrotic). Among the patients, 70.3% carried a methicillin resistant strain. Antibiotics per os were used for 83.3% of patients; the first-line antibiotics were considered inadequate in 53.3% of the cases. Among the patients, 83.3% underwent surgery. Fourteen out of 38 patients with available data had been exposed to antibiotic therapy during the three months before hospital management. Conclusion. - Recent exposure to antibiotics and living with a high number of persons are reasons to suspect a PVL producing S. aureus infection in patients with skin abscess. (c) 2012 Elsevier Masson SAS. All rights reserved.