Effect of the Panton – Valentine leukocidin gene Staphylococcus aureus on the course of the infectious process in orthopedic patients

Introduction Staphylococcus aureus is a leading pathogen causing osteoarticular infections. Panton – Valentine leukocidin (PVL) is considered one of the key of virulence factors with its role being poorly explored in orthopedic infections. The objective was to evaluate the occurrence of the PVL gene in S. aureus strains, the effect on laboratory markers of inflammation and on the course of the infectious process in orthopedic patients. Material and methods A retrospective analysis of 130 S. aureus strains isolated from 100 patients was performed. The presence of the lukS-PV and lukF-PV genes was determined using PCR. Laboratory parameters (CRP, ESR, leukocytes, neutrophils, and procalcitonin) and long-term treatment outcomes were assessed. Results PVL was detected in 15 % of strains S. aureus. No statistically significant effect of PVL on the levels of routine inflammatory markers was found. A key finding was that the presence of the PVL gene was associated with an increased risk of adverse outcome. Discussion The findings can be associated with debates on the clinical significance of PVL. Despite a significant impact on outcome The absence of significant differences in systemic inflammatory markers suggests that the negative effect of PVL is rather mediated by other mechanisms than by global inflammation activation measured by routine tests. These include direct cytotoxic tissue damage, impaired immune cell function, and the emergence of specific immunological processes. The association identified between PVL and the MRSA phenotype is consistent with the global epidemiological picture, where this toxin is a marker of hypervirulent community-acquired strains. Conclusion The presence of PVL is a significant risk factor for a poor outcome of orthopedic infection suggesting the need for its detection for risk stratification and optimization of patient management strategy. Conclusion The presence of PVL is a significant risk factor for an unfavorable outcome of orthopedic infection, which indicates the need for its detection for risk stratification and optimization of patient management tactics.