African Journal of Paediatric Surgery (Jan 2022)

Paediatric osteoarticular infections caused by staphylococcus aureus producing panton–valentine leucocidin in morocco: Risk factors and clinical features

  • Kaoutar Moutaouakkil,
  • Hicham Abdellaoui,
  • Btissam Arhoune,
  • Karima Atarraf,
  • Samira El Fakir,
  • Ghita Yahyaoui,
  • Mustapha Mahmoud,
  • Moulay Abderrahmane Afifi,
  • Bouchra Oumokhtar

DOI
https://doi.org/10.4103/ajps.AJPS_18_21
Journal volume & issue
Vol. 19, no. 2
pp. 78 – 82

Abstract

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Objective: We aimed to estimate the prevalence of Staphylococcus aureus producing Panton–Valentine leucocidin (PVL) isolated from children diagnosed with osteoarticular infections (OAIs), and to examine risk factors and clinical features. Methods: This prospective study was conducted from January 2017 to December 2018. All hospitalised children diagnosed with S. aureus OAI are included. Blood cultures, articular fluids, synovial tissues and/or bone fragments were collected for bacteriological culture. Antimicrobial susceptibility tests were determined by disk diffusion method. Genes encoding methicillin resistance (mecA) and PVL virulence factors (luk-S-PV and luk-F-PV) were detected by multiplex polymerase chain reaction. The demographic, clinical, laboratory, radiographic and clinical features were reviewed prospectively from medical records. Results: A total of 37 children with S. aureus OAIs were included, 46% of them have PVL-positive infection and 70.6% were male. The mean age was 8.12 years (±4.57), and almost were from rural settings (76.5%). Children with Staphylococcus aureus producing Panton–Valentine leucocidin (SA-PVL) were significantly associated with type of infection (P = 0.005), location of infection (P = 0.037) and abnormal X-ray (P = 0.029). All strains SA-PVL+ are sensitive to methicillin, but one strain SA-PVL negative was methicillin-resistant S. aureus, confirmed by gene mecA positive. Conclusion: The prevalence of S. aureus infections producing PVL toxin was high in OAIs amongst Moroccan children, mainly due to methicillin-susceptible S. aureus. Type and location of infections and abnormal X-ray were significantly associated with SA-PVL. Routine diagnostic testing of PVL-SA, continuous epidemiological surveillance and multidisciplinary management of OAI is essential to prevent serious complications.

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