Titel: Clinical presentation and secondary prevention of skin infection in patients with Panton-Valentine leukocidin (PVL)-producing S. aureus: A cohort study on the effectiveness of decolonization in an outpatient setting
Art: Abstractautor
Session: Workshop 05
Diagnostic Stewardship - "Meet the needs of your partners!" (FG DKM, FG QD)

Referent: Rasmus Leistner (Berlin)

Abstract - Text

Introduction/aim. Recurrent skin or soft tissue infections (SSTI) are often associated with Panton-Valentine leukocidin producing strains of S. aureus (PVL-SA). In order to prevent reinfection and spreading, decolonization measures are required in addition to treatment of active infections. Even though most PVL-SA patients are treated as outpatients, there are only a few studies assessing the effectiveness of outpatient decolonization in PVL-SA patients.


Material and methods. We assessed the results of decolonization for PVL-SA by a retrospective review of patient files and personal interviews. Successful decolonization was defined as the absence of any further SSTI for at least 6 months after the completion of the last decolonization treatment. Clinical and demographical data were assessed.


Results. Our cohort consisted of 67 index patients with recurrent skin abscesses due to PVL-SA. Additional 48 symptomatic and 40 asymptomatic contacts were identified by PVL-SA screening (n=155). Contact screening revealed household transmission of PVL-SA in 65% of cases.

92/97 PVL-SA-positive and symptomatic patients, were available for complete follow-up > 6 months. The mean follow-up was 15 months.   After completion of the first decolonization 47% were free of symptoms. Repeated decolonization increased the rate continuously to 100% after a maximum of five decolonization treatments. Successful eradication after first decolonization was significantly higher in single households compared to households with > 2 members (p < 0,001).


Conclusion. Decolonization is a successful preventive measure for reducing the risk for PVL-SA SSTI in the outpatient setting. Special attention should be given to patients with many close physical contacts as these settings could pose relevant decolonization hurdles.