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Several recent reports have suggested that community-associated meticillin-resistant Staphylococcus aureus (MRSA) clones, particularly those harbouring genes for Panton-Valentine leukocidin (PVL) or toxic shock syndrome toxin 1 (TSST-1), are increasingly responsible for infections in hospitals. Here, a retrospective study was carried out to investigate whether antimicrobial resistance patterns could be used to detect these pathogens in a French university hospital. Isolates were characterized by antimicrobial susceptibility testing, PCR profiling (PVL genes and tst), PFGE typing and multilocus sequence typing. Demographic and clinical data were collected from all patients. For PVL-positive MRSA, the typical antimicrobial resistance pattern (susceptible to fluoroquinolones, non-susceptible to fusidic acid, kanamycin resistant and susceptible to gentamicin and tobramycin) had a sensitivity of 77.8 % and a positive predictive value (PPV) of 100 %. For tst-positive MRSA, the antimicrobial resistance pattern (susceptible to fluoroquinolones and non-susceptible to fusidic acid) had a sensitivity of 100 % and a PPV of 72.4 %. These results suggest that phenotypic rules based on antimicrobial resistance patterns are potentially useful for the detection of PVL- and tst-positive MRSA isolates.

We report 4 cases of community-acquired infections due to Staphylococcus aureus producing Panton-Valentin leukocidin (SA-PVL) with uncommon multivisceral localizations. These cases highlight the need to screen for PVL in patients with serious staphylococcal infections. All patients were cured. Two of them received intravenous immunoglobulins in addition to antibiotics.

Milk from mastitis-free goats from French herds was examined for the presence of coagulase-negative staphylococci (CNS), and 165 positive isolates were evaluated for their capacity to produce exoproteins. Most isolates were identified as Staphylococcus caprae (N = 91) or S. xylosus (N = 36), but members of at least nine other species were present. Overall, some 57% of isolates produced toxins with phenotypic properties of alpha-hemolysin, and 75% produced toxins resembling S. aureus beta and/or delta-hemolysins. Thermostable desoxyribonuclease (TNAse) was secreted by 29% of isolates and thermolabile DNAse by 66%. Slime was produced by 42% of our cultures and, although none of them showed activity to insoluble elastase, over 70% lysed the soluble substrate. No clinical consequences were observed to correlate with exoprotein production, which proved to be inconstant within individual CNS species.