Clinical use
Identification of PVL producing strains of S. aureus. These may be methicillin sensitive (MSSA) or methicillin resistant (MRSA).
Background
Panton-valentine Leukocidin (PVL) is a toxin that destroys white blood cells and is a virulence factor in some strains of Staphylococcus aureus (SA). In the UK the genes encoding PVL are found in < 2% of S. aureus clinical isolates submitted to the National Reference Laboratory. Outbreaks in both community and healthcare settings can occur, and therefore it is important to identify PVL-SA. Clinical features of infection with PVL-SA include recurrent skin and soft tissue infection, necrotising fasciitis, osteomyelitis, pyomyositis and necrotising haemorrhagic pneumonia (often observed following a flu-like illness). Risk factors for infection with PVL-SA include:
- Close contact – households, military camps, contact sports
- Skin to skin contact, particularly with compromised skin integrity or uncovered lesions
- Sharing contaminated items – towels, bedding, other personal items etc
- Laundering contaminated items at temperatures below 60oC
Guidelines for the diagnosis and management of PVL-SA can be found on the government webpage for PVL- Staphylococcus aureus infections: diagnosis and management.
Specimen requirements
Samples to be sent for investigation of PVL producing S. aureus should be collected in line with specific collection instructions according to sample type. If S. aureus is grown clinicians can request PVL testing by calling the microbiology laboratory.
It is important to include as much clinical information as possible on request forms, this will enable the Microbiologist to identify cases which may be at risk of PVL and send these isolates for testing in a timely manner.
Turnaround time
Following identification in Microbiology, James Cook University Hospital the isolate is referred to the reference laboratory.
See individual specimen pages for internal culture turnaround times.
Referral lab turnaround time: 1-6 days
Analysing laboratory
UKHSA Colindale Bacteriology: AMRHAI (antimicrobial resistance and healthcare associated infections), UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ