PVL-producing Staphylococcus aureus infection

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I am responding to information already on patient plus about this infection. I am a consultant microbiologist and was interested to see what information was available. Unfortunately you have quoted the results of a study incorrectly. You state that \"recent evidence suggests that production of the toxins by this bacterium can be reduced by using antibiotics that inhibit cell wall synthesis and so they should be preferred. Beta lactams may produce a worse outcome in PVL-MRSA.\" In fact what the study states is that antimicrobials that affect protein synthesis (such as clindamycin or linezolid) are the ones that reduce toxin production. Cell-wall synthesis is affected by beta-lactam antibiotics (such as flucloxacillin), so your quoted information is contradictory. Also, it is misleading to say that beta-lactam antibiotics may produce a worse outcome in MRSA, as beta-lactam antibiotics are not ever used if it is known that the infection is caused by MRSA. It would be better to say: the use of sub-therapeutic doses of beta-lactams is associated with a poorer response as this encompasses both inadvertent use of beta-lactams in MRSA and the inappropriate use of low dose beta lactam therapy to treat MSSA skin sepsis.[/i]

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  • Posted

    dear dr.dobie ,my son has recently contracted pvl. in 2 wounds on his leg, he is in the forces and had abscesses excised in a hospital in germany .

    he is being treated with rifampicin and doxycycline and we are all decontaminating on monday with nasal cream and chlorhexidine washes . his wound is still open and i am dressing it myself .

    it sounds as though you have in depth knowledge on this subject and i am interested to know your views on the treatment provided and whether the decontamination of the rest of the family is effective when the leg wound is still very much open. i am a nurse and am currently unable to go to work because of this .

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  • Posted

    Our Thanks to Dr Dobie for his feedback. The record in question has been revised and will be reissued in due course.
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  • Posted

    Hi my name is sarah - i am a carrier of pvl and have been helped by a lovely lady micro - biologist called Marina - i have carried for 3 plus years and cant seem to remove from groin - any tips you can add - i have decol loads of times with hibi scrub. any other suggested things i can use - is tea tree effective? I am pregnant at the moment so have to be careful
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  • Posted

    My wife was in ayr hospital last year with a suspected heart attack.On her initial examination with a medical consultant,it was noted that she had an ulcerated foot.He took a swab of the open wound,and sent it off to microbiology for testing,when the test result came back the microbiologist reports that the wrong swab was used so they couldn't test it,no follow up test was done by the consultant.Eight days later it was found by my wifes consultant cardiologist that she had some sort of sepsis,when the results came back after growing a culture for 48 hours.My question is,shouldn't the microbiologist have made sure that after the initial test,the consultant be pushed to take a proper test using the correct type of swab.
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