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J Infect Dis. 2010 May 15;201(10):1589-97. doi: 10.1086/652008.

Global distribution and evolution of Panton-Valentine leukocidin-positive methicillin-susceptible Staphylococcus aureus, 1981-2007.

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Université Lyon 1, Centre National de Référence des Staphylocoques, and Institut National de la Santé et de la Recherche Médicale U851, Institut Fédératif de Recherche 128, Lyon, France.



Panton-Valentine leukocidin (PVL)-positive methicillin-susceptible Staphylococcus aureus and methicillin-resistant S. aureus (MSSA and MRSA, respectively) are both associated with severe infections, such as necrotizing pneumonia. The epidemiological profile of PVL-positive community-acquired (CA) MRSA has been extensively studied, but few corresponding data on PVL-positive MSSA are available.


The objectives of the study were to investigate the global population structure of PVL-positive MSSA, to compare it with that reported for CA-MRSA, and thus to examine the phylogenetic relationship between these pathogens.


We determined the agr types, multilocus sequence types, and toxin gene profiles of 211 PVL-positive MSSA clinical isolates collected in 19 countries throughout the world between 1981 and 2007.


The predominant lineages of PVL-positive MSSA were agr3/ST30, agr4/ST121, agr3/ST1, agr2/ST5, and agr3/ST80. Except for agr4/ST121, these lineages are also reported to be prevalent among CA-MRSA. PVL-positive MSSA lineages that are genetically related to CA-MRSA have gradually replaced other lineages (especially agr4/ST121) over the past 2 decades. Within a given sequence type, the toxin gene content of PVL-positive MSSA strains was very similar to that of PVL-positive CA-MRSA.


The molecular epidemiological profiles of PVL-positive MSSA and CA-MRSA are dynamically interrelated, with the former appearing to constitute a reservoir for the latter.

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