Lateral flow immunoassay for the Detection of Panton-Valentine leukocidin in Staphylococcus aureus from skin and soft tissue infections in the United Arab Emirates

Senok, Abiola, Monecke, Stefan, Nassar, Rania, Celiloglu, Handan, Thyagarajan, Sreeraj, Muller, Elke and Ehricht, Ralf 2021. Lateral flow immunoassay for the Detection of Panton-Valentine leukocidin in Staphylococcus aureus from skin and soft tissue infections in the United Arab Emirates. Frontiers in Cellular and Infection Microbiology 11 , 754523. 10.3389/fcimb.2021.754523

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Abstract

Introduction: Panton Valentine leukocidin (PVL) is a virulence factor which is associated with methicillin sensitive and resistant Staphylococcus aureus (MSSA/MRSA) causing skin and soft tissue infections (SSTI). This study aimed to evaluate a novel lateral flow immunoassay (LFI) for PVL detection in S. aureus cultures and to describe their genotypic characterization. Methods: The study was carried out from January-August 2020 in Dubai, United Arab Emirates. S. aureus isolates associated with SSTI were tested for PVL detection using LFI. DNA microarray-based assays were used for molecular characterization including detection of pvl genes. Results: One-hundred thirty-five patients with a clinical diagnosis of SSTIs were recruited. Sixty-six patients received antibiotics, mostly beta lactams (n=36) and topical fusidic acid (n=15). One-hundred twenty-nine isolates (MRSA: n=43; MSSA: n=86) were tested by LFI and DNA microarrays. All 76 (58.9%) isolates which were unambiguously negative for the PVL in LFI were negative for pvl genes using the DNA microarray. All the LFI PVL positive isolates (n=53) had pvl genes detected. This translates into 100% each for sensitivity, specificity, positive and negative predictive values for the LFI. The LFI typically takes about 15 min inclusive of a 10 min incubation period. Predominant S. aureus clonal complexes (CC) were CC30 (n=18), CC22 (n=13), CC5 (n=12), CC1 (n=11), CC152 (n=8), CC15 (n=7); CC97 (n=7); CC8 and CC20 (n=6 each). Among MRSA, the proportion of pvl-positives (35/43; 81%) was higher than among MSSA (n/N=18/86; 21%). The fusidic acid resistance gene fusC was detected in 14 MRSA (33%) compared to 8 MSSA (9%). A co-carriage of fusC and pvl genes was present in 7 MRSA and in one MSSA. Conclusion: LFI shows excellent diagnostic accuracy indices for rapid identification of PVL in MSSA/MRSA in a setting with high prevalence of pvl+ve strains. The high occurrence of pvl and fusC genes in MRSA strains causing SSTI is of concern and needs constant surveillance.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Dentistry
Additional Information:	This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY)
Publisher:	Frontiers Media
ISSN:	2235-2988
Date of First Compliant Deposit:	16 November 2021
Date of Acceptance:	13 September 2021
Last Modified:	03 May 2023 19:54
URI:	https://orca.cardiff.ac.uk/id/eprint/145519

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