Outbreak Of PVL-positive Community-associated MRSA, UK

Main Category: MRSA / Drug Resistance
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 19 Dec 2006 - 0:00 PDT

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Eight cases of Panton-Valentine Leukocidin (PVL)-positive community-associated MRSA have been identified among individuals in a hospital and their close household contacts in the West Midlands region. Four of these individuals developed an infection, two of whom subsequently died.

PVL-producing strains of MRSA have been seen in the UK before - however, the small numbers of cases reported have usually been in the community rather than a hospital setting. This outbreak is the first time transmission and deaths due to this strain are known to have occurred in a healthcare setting in England and Wales.

PVL-producing strains are more commonly contracted in the community and generally affect previously healthy young children and young adults - this contrasts with the so called 'hospital-associated MRSA' strains which do not produce PVL and are more commonly associated with causing wound infections and blood-poisoning in more elderly hospitalised patients.

Dr Angela Kearns, an MRSA expert with the Health Protection Agency, said: “When people contract PVL-producing strains of MRSA, they usually experience a skin infection such as a boil or abscess. Most infections can be treated successfully with everyday antibiotics but occasionally a more severe infection may occur.”

“The Health Protection Agency is advising the hospital on outbreak control measures, and will continue to monitor MRSA infection nationally.”

1. The infections are caused by strains of S. aureus which carry a toxin (PVL) that destroys white blood cells. The toxin is carried by less than 2% of S. aureus and can be carried by both those that are methicillin sensitive S. aureus (MSSA) and those that are methicillin resistant S. aureus (MRSA). To date the majority of PVL-related infections in the UK have been caused by MSSA.

2. Infections caused by PVL-positive strains of S. aureus normally cause pus-producing skin infections (eg abscesses or boils) and occasionally cellulitis or tissue necrosis. However they can cause more severe invasive infections such as septic arthritis, bacteraemia (blood poisoning) or community-acquired necrotising pneumonia.

3. To see the full article on this outbreak in the Communicable Disease Report weekly publication, click here.

Health Protection Agency (UK)

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