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Objectives: The aim of our study was to evaluate the frequency of osteoarticular infections with Panton-Valentine leukocidin-positive (PVL) Staphylococcus aureus (PVL-SA) among patients admitted to the orthopedic ward at the Sahloul University Hospital (Sousse, Tunisia) and to study the characteristics of these strains and patients., Materials and Methods: We conducted a retrospective descriptive study over a 5-year period. Bacterial identification, antibiotic susceptibility, and molecular study (PCR to detect of the luk-PV gene that encodes PVL) were performed for 44 S. aureus isolates., Results: Panton-Valentine toxin was found in 41% of S. aureus cases, mainly males, and 39% of the PVL(+) cases were methicillin-sensitive (MSSA). These strains constitute a reservoir of PVL genes that can lead to the emergence and spread of PVL-SA clones resistant to methicillin (MRSA). In our series, PVL-MRSA accounted for 9% of all S. aureus isolates. Their profile and antibiotic resistance is that of clone ST80, frequently isolated in Europe and also reported in Algeria and Tunisia., Conclusion: It is desirable to test for PVL routinely in the laboratory to implement appropriate treatment and to monitor the epidemiology of these PVL-SA strains actively. Further measures should be undertaken to prevent and fight infections by these strains.

Emerging strain of Stapylococcus aureus (S. aureus) producer of the Panton-Valentine Leukocidine (PVL+) are becoming a new issue in public health. Those bacteria are accountable for serious cutaneous infection with a necrotic evolution, necrotizing pneumonia and severe osteoarticular infection. These last infections can be life-threatening and are at high risk of complications. Therefore, a multidisciplinary approach is necessary, in addition with an aggressive chirurgical treatment. We are here reporting 3 cases of osteoarticular infections by S. aureus PVL+ sensitive to methicilline, which illustrate the difficulties encountered in the management and treatment, as well as the potential for serious orthopedics complications.

We report a patient who presented a severe Panton-Valentine-secreting methicillin-susceptible Staphylococcus aureus pneumonia with threatening multi-organ failure including acute respiratory distress syndrome, cardiac failure, renal failure and disseminated intravascular coagulation. Clinical and biological disease course using empiric therapy with treatment directed against toxin production (linezolid, clindamycin and intravenous immunoglobulins) was found to be quickly effective.

Background: Community-acquired pneumonia due to Panton-Valentine producing S.aureus is a serious infection recently described. Many cases have been reported worldwide., Aim: We report here the first case in Tunisia., Observation: Our patient is a previously healthy fourteen-year-old girl hospitalized for bilateral hypoxemic pneumonia. The clinical course had violently deteriorated two hours later, marked by massive hemoptysis that lead to rapid degradation of her hemodynamic state and death. Toxicologic research and bloodcultures were negatives. A post-mortem pleural specimen culture yielded a meticillin-resistant Staphylococcus aureus strain that carried the Panton-Valentine leucocidin genes., Conclusion: Community-acquired pneumonia due to Panton-Valentine producing Staphylococcus aureus is a serious affection unrecognized in our country. Thus, this pathogen must imperatively be included in the spectrum of those responsibles for pulmonary infections in children and young adults

Osteo-articular infections represent the majority of invasive Staphylococcus aureus infections in children. It is demonstrated that, independently of the resistance or susceptibility to methicillin, the production of Panton-Valentine leukocidin (PVL) by S. aureus enhanced the severity of the disease. However, an increase of the rate of community acquired methicillin-resistant S. aureus (CA-MRSA) has been reported in osteo-articular infections. These CA-MRSA are the most often susceptible to the other antibiotics. SCCmec elements of type IV or V associated with the PVL coding genes seem to be molecular markers of CA-MRSA. The risk factors of acquisition of these strains are the young age of children and the overcrowding. It is now established that CA-MRSA are pathogens present all over the world. It thus became necessary to look after the epidemiology of these virulent strains.

Panton-Valentine leukocidin-producing (PVL) Staphylococcus aureus is responsible for a highly lethal necrotizing pneumonia, which occurs predominantly in young immunocompetent patients. Hemoptysis and leucopenia often occur but are not always present. Detection of PVL gene on S. aureus strains responsible for pneumonia should help us to a better understanding of this disease, to improve its treatment with antibiotics capable of lower the toxin production and to prevent its diffusion to others persons by detection and elimination of a nasal S. aureus carriage.

Staphylococcal necrotizing pneumonia producing the Panton Valentine leukotoxin (PVL) has been described for many years. The french reference center for staphylococcal toxaemia defined it with precision in 1999. A 10-year-old child, died in 36 hours from respiratory distress and shock. Staphylococcal pneumonia was suspected then confirmed: S. Aureus producing PVL was isolated in lung, blood and articulations.