Disseminated cutaneous and pulmonary abscesses in an injecting drug user caused by a Panton-Valentine leucocidin-positive, methicillin-susceptible Staphylococcus aureus strain

Staphylococcus aureus is an important pathogen in injecting drug users. We illustrate this with a case of a young female patient who was admitted with multiple cutaneous and pulmonary abscesses. The causative strain was characterised using diagnostic microarrays. Genes encoding Panton-Valentine leucocidin (PVL) were detected, mecA was absent. The overall hybridisation profile allowed us to assign this isolate to ST152, being related to an epidemic community-acquired methicillin-resistant S. aureus (caMRSA) strain from south-eastern Europe. While PVLpositive MRSA has frequently been observed in injecting drug users, methicillin-susceptible isolates are usually not screened for the presence of PVL genes. The use of diagnostic microarrays contributes to patient care by the simultaneous detection of resistance and virulence markers. It also facilitates the study of phylogenetic relationships of epidemic strains.