alpha-Hemolysin, Not Panton-Valentine Leukocidin, Impacts Rabbit Mortality from Severe Sepsis With Methicillin-Resistant Staphylococcus aureus Osteomyelitis

作者：Cremieux Anne Claude^*; Saleh Mghir Azzam; Danel Claire; Couzon Florence; Dumitrescu Oana; Lilin Thomas; Perronne Christian; Etienne Jerome; Lina Gerard; Vandenesch Francois

来源：Journal of Infectious Diseases, 2014, 209(11): 1773-1780.

DOI：10.1093/infdis/jit840

• Staphylococcus aureus
• CA-MRSA
• osteomyelitis
• severe sepsis
• Panton-Valentine leukocidin
• alpha-hemolysin
• rabbit model

Background. Severe sepsis, combining acute osteomyelitis and lung involvement, has been described increasingly in healthy children with the spread of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). %26lt;br%26gt;Methods.aEuro integral Outcomes (mortality, hematogenous spread, lung and bone involvements) of rabbit osteomyelitis caused by CA-MRSA LAC(WT) USA300 and its Panton-Valentine leukocidin (PVL)- and alpha-hemolysin (Hla)-negative isogenic derivatives (LAC Delta pvl and LAC Delta hla, respectively) were compared. %26lt;br%26gt;Results.aEuro integral Three days after inoculation (D3), all LAC(WT)- and LAC Delta pvl-, and 72% of LAC Delta hla-infected rabbits had no hematogenous spread and similar lung and bone bacterial densities. LAC Delta pvl and LAC Delta hla caused less severe histological lung lesions than LAC(WT) (P a parts per thousand currency sign .01). Between D3 and D9, 10 (53%) LAC(WT)-, 11 (55%) LAC Delta pvl-, but no LAC Delta hla-infected rabbits (P %26lt; .005) died of severe sepsis with disseminated infection. Unlike deceased animals, most LAC(WT), LAC Delta pvl, and LAC Delta hla D14 survivors had no hematogenous spread (P %26lt; .001). LAC(WT) (88%) caused more bone abscesses than LAC Delta pvl (0, P = .001) or LAC Delta hla (30%, P = .01). %26lt;br%26gt;Conclusion.aEuro integral In this model, both PVL and Hla seemed to be required for early lung involvement via hematogenous spread. Hla, but not PVL, significantly impacted severe sepsis-related mortality. PVL was the predominant factor determining late-stage bone abscesses.

• 出版日期2014-6-1