4 research outputs found
Panton-Valentine Leukocidin Is Not the Primary Determinant of Outcome for Staphylococcus aureus Skin Infections: Evaluation from the CANVAS Studies
The impact of Panton-Valentine leukocidin (PVL) on the severity of complicated skin and skin structure infections (cSSSI) caused by Staphylococcus aureus is controversial. We evaluated potential associations between clinical outcome and PVL presence in both methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) isolates from patients enrolled in two large, multinational phase three clinical trials assessing ceftaroline fosamil for the treatment of cSSSI (the CANVAS 1 and 2 programs). Isolates from all microbiologically evaluable patients with monomicrobial MRSA or MSSA infections (n = 473) were genotyped by PCR for pvl and underwent pulsed-field gel electrophoresis (PFGE). Genes encoding pvl were present in 266/473 (56.2%) isolates. Infections caused by pvl-positive S. aureus were associated with younger patient age, North American acquisition, and presence of major abscesses (P<0.001 for each). Cure rates of patients infected with pvl-positive and pvl-negative S. aureus were similar overall (93.6% versus 92.8%; P = 0.72), and within MRSA-infected (94.5% vs. 93.1%; P = 0.67) and MSSA-infected patients (92.2% vs. 92.7%; P = 1.00). This finding persisted after adjustment for multiple patient characteristics. Outcomes were also similar when USA300 PVL+ and non-USA300 PVL+ infections were compared. The results of this contemporary, international study suggest that pvl presence was not the primary determinant of outcome in patients with cSSSI due to either MRSA or MSSA
Baseline characteristics of 473 patients with <i>S. aureus</i> complicated skin and skin structure infections (cSSSI) stratified by methicillin-resistance and <i>pvl</i> gene status of the infecting pathogen.
*<p> = P-Value from generalized 2-sided Fishers Exact Test. Calculated using 7×2 table (<sup>∧</sup>), 4×2 table (§) and 3×2 table (±).</p>**<p> = P-Value from 2-sided T-test.</p>***<p> = P-value from Wilcoxon Rank Sum test.</p><p>1 = Subjects with missing data were not included in these summaries.</p
Clinical outcome of cure for 473 patients with methicillin-resistant and methicillin-susceptible <i>S. aureus</i> complicated skin and skin structure infections by <i>pvl</i> gene status, stratified by infection severity, diabetes, patient age, and study medication.
*<p> = P-Value from generalized 2-sided Fishers Exact Test.</p><p>Missing categories are not in the analyses.</p
Clinical outcome of cure for 266 patients with <i>pvl</i> positive <i>S. aureus</i> complicated skin and skin structure infections by pulsed-field gel type, stratified by infection severity, diabetes, patient age, methicillin-susceptibility and study medication.
*<p> = P-Value from generalized 2-sided Fishers Exact Test.</p>**<p>Receipt of a surgical procedure ≤48 hours post enrolment.</p><p>Missing categories are not in the analyses.</p