Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin

Kevin P. Blaine; Marion J. Tuohy; Deborah Wilson; Gary W. Procop; Daniel J. Tisch; Nabin K. Shrestha; Geraldine S. Hall

doi:10.1016/j.diagmicrobio.2010.04.013

Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin

Kevin P. Blaine
, Marion J. Tuohy
, Deborah Wilson
, Gary W. Procop
, Daniel J. Tisch
, Nabin K. Shrestha
, Geraldine S. Hall

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

The role of Panton-Valentine leukocidin (PVL) in methicillin-resistant Staphylococcus aureus (MRSA) infections is unclear. PVL has been long associated with soft tissue infections and necrotizing pneumonia, but inconsistently with other site infections or mortality. The retrospective cohort study explores the association between PVL and bacteremia in colonized medical intensive care unit (ICU) patients with surveillance isolates and blood cultures. A total of 840 patients were screened by nasal swab, with 266 patients found to be colonized and 46 with bacteremia. Colonization by PVL⁺ MRSA increased the odds of bacteremia (odds ratio, 2.40; confidence interval, 1.23-4.57), and invasive infection developed earlier in these patients (relative risk, 0.44; confidence interval 0.25-0.85) compared to those colonized with PVL⁰ MRSA. PVL was not associated with infections at other sites, length of ICU stay, or mortality. PVL decreases the time to bacteremia in colonized patients but does not otherwise contribute to disease course or clinical outcome.

Original language	English (US)
Pages (from-to)	28-33
Number of pages	6
Journal	Diagnostic Microbiology and Infectious Disease
Volume	68
Issue number	1
DOIs	https://doi.org/10.1016/j.diagmicrobio.2010.04.013
State	Published - Sep 2010
Externally published	Yes

Funding

The authors wish to acknowledge the assistance of the Cleveland Clinic medical ICU for collection of nasal samples. They also wish to thank Alejandro Arroliga, MD, presently at Scott and White Healthcare of Temple, Texas. Financial support was provided by the Cleveland Clinic Foundation. The authors have no conflicts of interest to report.

Funders
The Cleveland Clinic Foundation

Keywords

Bacteremia
ICU infections
Methicillin-resistant Staphylococcus aureus
Nasal colonization
Panton-Valentine leukocidin

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1016/j.diagmicrobio.2010.04.013

Cite this

Blaine, K. P., Tuohy, M. J., Wilson, D., Procop, G. W., Tisch, D. J., Shrestha, N. K., & Hall, G. S. (2010). Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin. Diagnostic Microbiology and Infectious Disease, 68(1), 28-33. https://doi.org/10.1016/j.diagmicrobio.2010.04.013

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title = "Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin",

abstract = "The role of Panton-Valentine leukocidin (PVL) in methicillin-resistant Staphylococcus aureus (MRSA) infections is unclear. PVL has been long associated with soft tissue infections and necrotizing pneumonia, but inconsistently with other site infections or mortality. The retrospective cohort study explores the association between PVL and bacteremia in colonized medical intensive care unit (ICU) patients with surveillance isolates and blood cultures. A total of 840 patients were screened by nasal swab, with 266 patients found to be colonized and 46 with bacteremia. Colonization by PVL+ MRSA increased the odds of bacteremia (odds ratio, 2.40; confidence interval, 1.23-4.57), and invasive infection developed earlier in these patients (relative risk, 0.44; confidence interval 0.25-0.85) compared to those colonized with PVL0 MRSA. PVL was not associated with infections at other sites, length of ICU stay, or mortality. PVL decreases the time to bacteremia in colonized patients but does not otherwise contribute to disease course or clinical outcome.",

keywords = "Bacteremia, ICU infections, Methicillin-resistant Staphylococcus aureus, Nasal colonization, Panton-Valentine leukocidin",

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note = "Funding Information: The authors wish to acknowledge the assistance of the Cleveland Clinic medical ICU for collection of nasal samples. They also wish to thank Alejandro Arroliga, MD, presently at Scott and White Healthcare of Temple, Texas. Financial support was provided by the Cleveland Clinic Foundation. The authors have no conflicts of interest to report.",

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AU - Wilson, Deborah

AU - Procop, Gary W.

AU - Tisch, Daniel J.

AU - Shrestha, Nabin K.

AU - Hall, Geraldine S.

N1 - Funding Information: The authors wish to acknowledge the assistance of the Cleveland Clinic medical ICU for collection of nasal samples. They also wish to thank Alejandro Arroliga, MD, presently at Scott and White Healthcare of Temple, Texas. Financial support was provided by the Cleveland Clinic Foundation. The authors have no conflicts of interest to report.

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N2 - The role of Panton-Valentine leukocidin (PVL) in methicillin-resistant Staphylococcus aureus (MRSA) infections is unclear. PVL has been long associated with soft tissue infections and necrotizing pneumonia, but inconsistently with other site infections or mortality. The retrospective cohort study explores the association between PVL and bacteremia in colonized medical intensive care unit (ICU) patients with surveillance isolates and blood cultures. A total of 840 patients were screened by nasal swab, with 266 patients found to be colonized and 46 with bacteremia. Colonization by PVL+ MRSA increased the odds of bacteremia (odds ratio, 2.40; confidence interval, 1.23-4.57), and invasive infection developed earlier in these patients (relative risk, 0.44; confidence interval 0.25-0.85) compared to those colonized with PVL0 MRSA. PVL was not associated with infections at other sites, length of ICU stay, or mortality. PVL decreases the time to bacteremia in colonized patients but does not otherwise contribute to disease course or clinical outcome.

AB - The role of Panton-Valentine leukocidin (PVL) in methicillin-resistant Staphylococcus aureus (MRSA) infections is unclear. PVL has been long associated with soft tissue infections and necrotizing pneumonia, but inconsistently with other site infections or mortality. The retrospective cohort study explores the association between PVL and bacteremia in colonized medical intensive care unit (ICU) patients with surveillance isolates and blood cultures. A total of 840 patients were screened by nasal swab, with 266 patients found to be colonized and 46 with bacteremia. Colonization by PVL+ MRSA increased the odds of bacteremia (odds ratio, 2.40; confidence interval, 1.23-4.57), and invasive infection developed earlier in these patients (relative risk, 0.44; confidence interval 0.25-0.85) compared to those colonized with PVL0 MRSA. PVL was not associated with infections at other sites, length of ICU stay, or mortality. PVL decreases the time to bacteremia in colonized patients but does not otherwise contribute to disease course or clinical outcome.

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KW - Nasal colonization

KW - Panton-Valentine leukocidin

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Progression to bacteremia in critical care patients colonized with methicillin-resistant Staphylococcus aureus expressing Panton-Valentine leukocidin

Abstract

Funding

Keywords

ASJC Scopus subject areas

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