Is Panton-Valentine leucocidin (PVL) toxin associated with poor clinical outcomes in patients with community-acquired Staphylococcus aureus bacteraemia?

Emma McGuire*, Claire Neill, Simon M. Collin, Hannah Higgins, Rebecca Guy, Mark Ganner, Juliana Coelho, Bruno Pichon, Russell Hope, Colin S. Brown

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)

Abstract

Introduction. Panton-Valentine leucocidin (PVL) toxin is a potential determinant of virulence associated with S. aureus infection.Gap Statement. The contribution of PVL to S. aureus pathogenicity remains unclear.

Aim. To compare clinical outcomes in hospitalized patients with PVL-positive and PVL-negative community-acquired (CA) S. aureus bacteraemia.

Methods. Three national datasets were combined to provide clinical and mortality data for patients with CA S. aureus blood culture isolates sent to the UK reference laboratory for PVL testing, August 2018 to August 2021. Multivariable logistic regression models were built for the effect of PVL positivity on 30 day all-cause mortality and 90 day readmission.

Results. In 2191 cases of CA S. aureus bacteraemia, there was no association between PVL and mortality (adjusted odds ratio, aOR: 0·90, 95 % confidence interval, CI: 0·50-1·35, P=0·602) and no difference in median LOS (14 versus 15 days, P=0.169). PVL-positive cases had lower odds of readmission (aOR 0·74, CI 0·55-0.98, P=0·038). There was no evidence that MRSA status modified this effect (P=0·207).Conclusions. In patients with CA S. aureus bacteraemia PVL toxin detection was not associated with worse outcomes.

Original languageEnglish
Article number001683
JournalJournal of Medical Microbiology
Volume72
Issue number4
DOIs
Publication statusPublished - 25 Apr 2023

Bibliographical note

Funding Information:
The authors wish to thank clinicians, microbiologists and laboratory teams from NHS Trusts in England for referring Staphylococcus aureus isolates to the Staphylococcus and Streptococcus Reference Section (SSRS) at the Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI), UK Health Security Agency.

Publisher Copyright:
© 2023 Crown Copyright.

Keywords

  • luk-PV
  • Panton–Valentine leukocidin
  • PV leukocidin
  • PVL toxin, Staphylococcus aureus
  • Staphylococcus aureus

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