The genus Staphylococcus are pathogenic bacterium found in humans and other mammals. Traditionally they were divided into two sub-groups based on the coagulase reaction. Staphylcocci are generally found inhabiting the skin and mucous membranes of mammals and birds. Some members of this genus can be found as human commensals and these are generally believed to have the greatest pathogenic potential in opportunistic infections of humans.
This bacterial strain is a major cause of nosocomial (hospital-acquired) and community-acquired infections. Since its discovery as an opportunistic pathogen, Staphylococcus aureus continues to be a major cause of mortality and is responsible for a wide variety of infections, including; boils, furuncles, styes, impetigo and other superficial skin infections in humans. Staph.aureus is also known to cause more serious infections, particularly in the chronically ill or immunocompromised. These include pneumonia, deep abscesses, osteomyelitis, endocarditis, phlebitis, mastitis and meningitis. The ability to cause invasive disease is associated with persistance in the nasal cavity of a host and is commonly recognised as 'colonization'.
Staphylococcus aureus USA300. USA300, is a methicillin resistant strain of Staphylococcus aureus - MRSA. It has been implicated in epidemiologically unassociated outbreaks of skin and soft tissue infections among healthy individuals in at least 24 U.S. states, Canada and Europe. USA300 is also noted for its strong association with unusually invasive pathogenic diseases, which include; severe septicemia, necrotizing pneumonia and necrotizing fasciitis.
This disease is one of the quickest-spreading infections known to man, as it spreads easily and rapidly across the fascial plane within the subcutaneous tissue. For this reason, it is popularly called the “flesh-eating bug,” and although once quite rare, but now on the increase, it became well-known to the general public in the 1990's. Even with todays modern medicines, the prognosis can be bleak, with a mortality rate of approximately 25-35% with severe disfigurement common in survivors.
PVL - Panton Valentine Leukocidin
It has been found that MRSA strains can also contain genes that encode the panton valentine leukocidin toxin (PVL). The PVL toxin has been shown to be responsible for many of the severe clinical symptoms of infection with MRSA, such as furunculosis, severe necrotizing pneumonia, and necrotic lesions of the skin and soft tissues.
According to a report that reveals the true extent of the MRSA crisis in Britain, it appears that the UK has the worst record amongst the larger European Nations.
To make matters worse, a new 'Superbug' type of MRSA has killed a Nurse and a patient at an undisclosed hospital in the United Kingdom.
The hospital, which is located in the West Midlands, claimed that a total of eight people were infected and that two have already died. Four others have abscesses and boils as a result of this outbreak. This new 'superbug' which is known as 'PVL-producing MRSA' is in fact not new at all. It is a resurgence of a strain that was detected back in the 1930's. It had accounted for around 60 per cent of all staphylococcus infections before the year 1960.
The report also disclosed that over 88% of hospital nursing staff, doctors and specialists, were failing to observe proper washing proceedures when dealing with already infected patients. The new outbreak of PVL, (Panton Valentine Leukocidin), which causes 'necrotising fasciitis' or 'flesh eating bacteria' has been associated with the new upsurge in general MRSA outbreaks and more resistant strains that have developed by the overuse of medical antibiotics.
According to Government guidelines, hospitals only have to report 'bacteremia' which are bloodstream infections and the underlying rate of MRSA goes mostly unreported. The true figures seem to be between 25,000 and 30,000 cases a year. Urinary Tract Infections (UTI's) are also exempt from reporting.
Around 50% of all cases in UK hospitals have the 'drug resistant' type of Staphylococcus aureus, MRSA. The cases in intensive care units are even higher at 65-70%, while our top-performing European neighbours have a level of 10% or less. In Norway, Sweden, Denmark and Finland, MRSA cases are very rare. In France, there is about a 20% infection rate.
Panton-Valentine leukocidin (PVL) is a cytotoxin that causes leukocyte destruction and tissue necrosis. It is produced by fewer than 5% of Staphylococcus aureus strains. A collection of 172 S. aureus strains were screened for PVL genes by polymerase chain reaction amplification. PVL genes were detected in 93% of strains associated with furunculosis and in 85% of those associated with severe necrotic hemorrhagic pneumonia (all community-acquired). They were detected in 55% of cellulitis strains, 50% of cutaneous abscess strains, 23% of osteomyelitis strains, and 13% of finger-pulp-infection strains. PVL genes were not detected in strains responsible for other infections, such as infective endocarditis, mediastinitis, hospital-acquired pneumonia, urinary tract infection, and enterocolitis, or in those associated with toxic-shock syndrome. It thus appears that PVL is mainly associated with necrotic lesions involving the skin or mucosa.
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