Summary
Staphylococcus aureus is a frequent cause of purulent skin infections in travellers returning from the tropics and subtropics. This review gives an account of the current knowledge on travel-related, S. aureus positive skin infections with a focus on recent findings on both bacterial pathogenicity and mechanisms of innate defence. In particular, the potential role of community-acquired methicillin-resistance, Panton-Valentine leukocidin as well as antimicrobial peptides in the evolution of this type of infection are discussed. Moreover, conflicting findings for a possible association of travel and migration with the global emergence of community-acquired methicillin-resistant S. aureus infections are summarised. This review highlights areas of uncertainty that require further investigation.
Zusammenfassung
Staphylococcus aureus kann häufig als Ursache eitriger Hautinfektionen bei Rückkehrern aus den Tropen und Subtropen isoliert werden In dieser Übersichtsarbeit wird der aktuelle Wissenstand zu reiseassoziierten, S aureus positiven Hautinfektionen referiert, Wobei neuere Erkenntnisse sowohl zu Pathogenitätsfaktoren als auch zu angeborenen Immunmechanismen besondere Berücksichtigung finden. Neben der Bedeutung einer Methicillinresistenz und des Panton-Valentine Leukozidin bei der Entstehung dieser Infektionen wird die Rolle antimikrobieller Peptide bei deren Abwehr dargestellt. Widersprüchliche Beobachtungen zu einer möglichen Bedeutung internationaler Reise- und Migrationsbewegungen für die weltweite Zunahme von ambulant erworbenen Infektionen mit Methicillin-resistenten S. aureus-Stämmen werden zusammengefasst. Bislang noch ungeklärte Fragestellungen und damit der weitere Forschungsbedarf auf diesem Gebiet werden ebenfalls aufgezeigt.
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References
Ansart S, Perez L, Jaureguiberry S, Danis M, Bricaire F, Caumes E (2007) Spectrum of dermatoses in 165 travelers returning from the tropics with skin diseases. Am J Trop Med Hyg 76: 184–6
Caumes E, Carriere J, Guermonprez G, Bricaire F, Danis M, Gentilini M (1995) Dermatoses associated with travel to tropical countries: a prospective study of the diagnosis and management of 269 patients presenting to a tropical disease unit. Clin Infect Dis 20: 542–8
Denis O, Deplano A, De Beenhouwer H, Hallin M, Huysmans G, Garrino MG, et al (2005) Polyclonal emergence and importation of community-acquired methicillin-resistant Staphylococcus aureus strains harbouring Panton-Valentine leucocidin genes in Belgium. J Antimicrob Chemother 56: 1103–6
Ellington MJ, Ganner M, Warner M, Boakes E, Cookson BD, Hill RL, et al (2009) First international spread and dissemination of the virulent Queensland community associated-MRSA strain. Clin Microbiol Infect (Epub ahead of print)
Francois P, Harbarth S, Huyghe A, Renzi G, Bento M, Gervaix A, et al (2008) Methicillin-resistant Staphylococcus aureus, Geneva, Switzerland, 1993–2005. Emerg Infect Dis 14: 304–7
Larsen AR, Stegger M, Bocher S, Sorum M, Monnet DL, Skov RL (2009) Emergence and characterization of community-associated methicillin-resistant Staphyloccocus aureus infections in Denmark, 1999–2006. J Clin Microbiol 47: 73–8
Maier J, Melzl H, Reischl U, Drubel I, Witte W, Lehn N, et al (2005) Panton-Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus in Germany associated with travel or foreign family origin. Eur J Clin Microbiol Infect Dis 24: 637–9
Rossney AS, Shore AC, Morgan PM, Fitzgibbon MM, O'Connell B, Coleman DC (2007) The emergence and importation of diverse genotypes of methicillin-resistant Staphylococcus aureus (MRSA) harboring the Panton-Valentine leukocidin gene (PVL) reveal that PVL is a poor marker for community-acquired MRSA strains in Ireland. J Clin Microbiol 45: 2554–63
Schleucher RD, Gaessler M, Knobloch J (2008) Panton-Valentine leukocidin-producing methicillin-sensitive Staphylococcus aureus as a cause for recurrent, contagious skin infections in young, healthy travelers returned from a tropical country: a new worldwide public health problem? J Travel Med 15: 137–9
Hochedez P, Canestri A, Lecso M, Valin N, Bricaire F, Caumes E (2009) Skin and soft tissue infections in returning travelers. Am J Trop Med Hyg 80: 431–4
Helgason KO, Jones ME, Edwards G (2008) Panton-Valentine leukocidin-positive Staphylococcus aureus and foreign travel. J Clin Microbiol 46: 832–3
Schröder JM, Harder J (2006) Antimicrobial skin peptides and proteins. Cell Mol Life Sci 63: 469–86
Freedman DO, Weld LH, Kozarsky PE, Fisk T, Robins R, von Sonnenburg F, et al (2006) Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354: 119–30
Elliot AJ, Cross KW, Smith GE, Burgess IF, Fleming DM (2006) The association between impetigo, insect bites and air temperature: a retrospective 5-year study (1999–2003) using morbidity data collected from a sentinel general practice network database. Fam Pract 23: 490–6
Wertheim HF, Melles DC, Vos MC, van Leeuwen W, van Belkum A, Verbrugh HA, et al (2005) The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 5: 751–62
Durupt F, Mayor L, Bes M, Reverdy ME, Vandenesch F, Thomas L, et al (2007) Prevalence of Staphylococcus aureus toxins and nasal carriage in furuncles and impetigo. Br J Dermatol 157: 1161–7
Naimi TS, LeDell KH, Como-Sabetti K, Borchardt SM, Boxrud DJ, Etienne J, et al (2003) Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. Jama 290: 2976–84
Groom AV, Wolsey DH, Naimi TS, Smith K, Johnson S, Boxrud D, et al (2001) Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. Jama 286: 1201–5
Nübel U, Roumagnac P, Feldkamp M, Song JH, Ko KS, Huang YC, et al (2008) Frequent emergence and limited geographic dispersal of methicillin-resistant Staphylococcus aureus. Proc Natl Acad Sci USA 105: 14130–5
Vandenesch F, Naimi T, Enright MC, Lina G, Nimmo GR, Heffernan H, et al (2003) Community-acquired methicillin-resistant Staphylococcus aureus carrying Panton-Valentine leukocidin genes: worldwide emergence. Emerg Infect Dis 9: 978–84
Zanger P, Holzer J, Schleucher R, Steffen H, Schittek B, Gabrysch S (2009) Constitutive expression of the antimicrobial peptide RNase 7 is associated with Staphylococcus aureus infection of the skin. J Infect Dis 200: 1907–15
Zanger P, Holzer J, Schleucher R, Steffen H, Schittek B, Gabrysch S (2009) The antimicrobial peptide RNase 7 protects travellers from Staphylococcus aureus infection of the skin. Trop Med Int Health 14(s2): 218
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Zanger, P. Staphylococcus aureus positive skin infections and international travel. Wien Klin Wochenschr 122 (Suppl 1), 31–33 (2010). https://doi.org/10.1007/s00508-010-1333-1
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DOI: https://doi.org/10.1007/s00508-010-1333-1