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P.V.L. Christopher Jones 2011. What is it NOT? MRSA ESBL Any other form of antibiotic resistant bacterium (Although antibiotic resistance might be incidentally.

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Presentation on theme: "P.V.L. Christopher Jones 2011. What is it NOT? MRSA ESBL Any other form of antibiotic resistant bacterium (Although antibiotic resistance might be incidentally."— Presentation transcript:

1 P.V.L. Christopher Jones 2011

2 What is it NOT? MRSA ESBL Any other form of antibiotic resistant bacterium (Although antibiotic resistance might be incidentally present)

3 What is it then? Panton-Valentine Leukocidin A virulence enhancing cytotoxin Discovered in 1894 Named after Sir Philip Noel Panton and Francis Valentine after they associated it with soft tissue infections in 1932

4 Where does it come from? Arises as a result of bacteriophage infection of Staph Aureus (MSSA or MRSA) Genetic material integrated into the bacterial chromosome

5 What does it do? Causes a release of two proteins (LukS- PV & Lukf-PV) from the bacterium These join together to form a protein ring in the membrane of host cells (esp white blood cells) with a central pore Result in leakage of intracellular contents and formation of superantigens, undermining targeted immune response

6 Why is it significant? (medically) Aggressive Staph Aureus infection Causes severe local tissue necrosis Necrotising fasciitis Necrotising Pneumonia.....

7 Necrotising Pneumonia PVL pneumonia Necrotising vasculitis Pulmonary haemorrhage Pulmonary infarction Leukopenia (from destruction of WBCs) Shock 75% mortality if not diagnosed early and treated aggressively.

8 Why is it significant? (epidemiologically) Linked to: –Overcrowding –Communal residences –Contact sports –Skin damage Local Royal Marine base

9 Management Consider possibility of diagnosis (especially in infection in healthy adults) Appropriate infection control measures Microbiology – culture and sensitivity “Virology” – polymerase chain reaction testing Antimicrobials MSSA: flucloxacillin, erythromycin, clindamycin MRSA: clindamycin, rifampicin and doxycycline or fusidic acid or trimethoprim

10 Infection Control Remember: –The microbiologists are your friends –The infection control nurses are not always your enemies

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