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Prevalence of community-associated meticillin-resistant Staphylococcus aureus and Panton–Valentine leucocidin-positive S. aureus in general practice patients with skin and soft tissue infections in the northern and southern regions of The Netherlands

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Abstract

The purpose of this investigation was to determine the prevalence of community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) and Panton–Valentine leucocidin (PVL)-positive S. aureus in general practice (GP) patients with skin and soft tissue infections (SSTI) in the northern (Groningen and Drenthe) and southern (Limburg) regions of The Netherlands. Secondary objectives were to assess the possible risk factors for patients with SSTI caused by S. aureus and PVL-positive S. aureus using a questionnaire-based survey. From 2007 to 2008, wound and nose cultures were obtained from patients with SSTI in general practice. These swabs were analysed for the presence of S. aureus and the antibiotic susceptibility was determined. The presence of the PVL toxin gene was determined by polymerase chain reaction (PCR) and the genetic background with the use of spa typing. A survey was performed to detect risk factors for S. aureus infection and for the presence of PVL toxin.S. aureus was isolated from 219 out of 314 (70%) patients with SSTI, of which two (0.9%) patients were MRSA-positive. In 25 (11%) patients, the PVL toxin gene was found. A higher prevalence of PVL-positive S. aureus of patients with SSTI was found in the northern region compared to the south (p < 0.05). Regional differences were found in the spa types of PVL-positive S. aureus isolates, and for PVL-negative S. aureus isolates, the genetic background was similar in both regions. The prevalence of CA-MRSA in GP patients with SSTI in The Netherlands is low. Regional differences were found in the prevalence of PVL-positive S. aureus isolates from GP patients with SSTI. Household contacts having similar symptoms were found to be a risk factor for SSTI with S. aureus.

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Acknowledgements

We thank the technicians from the laboratory of medical microbiology of the Laboratory for Infectious Diseases in Groningen and the Maastricht University Medical Centre for the technical assistance and support.

Funding

This work was supported in part by a grant from the Ministry of Health, Welfare and Sports, The Netherlands.

Conflict of interest

None declared.

Ethical approval

Medical ethical approval was given by Mr. John W.P. de Vroedt, MHA, Maastricht University Medical Centre and University Hospital of Groningen. This study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Laboratory for Infectious Diseases, van Ketwich Verschuurlaan 92, 9721 SW, Groningen, The Netherlands

    D. Mithoe & A. V. M. Möller

  2. Martini Hospital, van Swietenplein 1, 9728 NT, Groningen, The Netherlands

    D. Mithoe & A. V. M. Möller

  3. Department of Medical Microbiology, Maastricht University Medical Centre, School for Public Health and Primary Care (CAPHRI), P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    M. I. A. Rijnders & E. Stobberingh

  4. The National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands

    B. M. Roede

Authors
  1. D. Mithoe
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  2. M. I. A. Rijnders
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  3. B. M. Roede
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  4. E. Stobberingh
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  5. A. V. M. Möller
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Correspondence to D. Mithoe.

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Mithoe, D., Rijnders, M.I.A., Roede, B.M. et al. Prevalence of community-associated meticillin-resistant Staphylococcus aureus and Panton–Valentine leucocidin-positive S. aureus in general practice patients with skin and soft tissue infections in the northern and southern regions of The Netherlands. Eur J Clin Microbiol Infect Dis 31, 349–356 (2012). https://doi.org/10.1007/s10096-011-1316-9

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  • DOI: https://doi.org/10.1007/s10096-011-1316-9

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