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PMID- 29261764
OWN - NLM
STAT- MEDLINE
DCOM- 20180108
LR  - 20180108
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Pyoderma outbreak among kindergarten families: Association with a
      Panton-Valentine leukocidin (PVL)-producing S. aureus strain.
PG  - e0189961
LID - 10.1371/journal.pone.0189961 [doi]
AB  - OBJECTIVES: We report on an outbreak of skin and soft tissue infections (SSTI)
      among kindergarten families. We analyzed the transmission route and aimed to
      control the outbreak. METHODS: The transmission route was investigated by nasal
      screening for Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus
      (PVL-SA), subsequent microbiological investigation including whole genome
      sequencing and a questionnaire-based analysis of epidemiological information. The
      control measures included distribution of outbreak information to all individuals
      at risk and implementation of a Staphylococcus aureus decontamination protocol.
      RESULTS: Individuals from 7 of 19 families were either colonized or showed signs 
      of SSTI such as massive abscesses or eye lid infections. We found 10 PVL-SA
      isolates in 9 individuals. In the WGS-analysis all isolates were found identical 
      with a maximum of 17 allele difference. The clones were methicillin-susceptible
      but cotrimoxazole resistant. In comparison to PVL-SAs from an international
      strain collection, the outbreak clone showed close genetical relatedness to
      PVL-SAs from a non-European country. The questionnaire results showed frequent
      travels of one family to this area. The results also demonstrated likely
      transmission via direct contact between families. After initiation of
      Staphylococcus aureus decontamination no further case was detected. CONCLUSIONS: 
      Our outbreak investigation showed the introduction of a PVL-SA strain into a
      kindergarten likely as a result of international travel and further transmission 
      by direct contact. The implementation of a Staphylococcus aureus decontamination 
      protocol was able to control the outbreak.
FAU - Leistner, Rasmus
AU  - Leistner R
AUID- ORCID: http://orcid.org/0000-0002-1225-9023
AD  - Institute of Hygiene and Environmental Medicine, Charite Universitatsmedizin
      Berlin, Berlin, Germany.
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
FAU - Kola, Axel
AU  - Kola A
AD  - Institute of Hygiene and Environmental Medicine, Charite Universitatsmedizin
      Berlin, Berlin, Germany.
FAU - Gastmeier, Petra
AU  - Gastmeier P
AD  - Institute of Hygiene and Environmental Medicine, Charite Universitatsmedizin
      Berlin, Berlin, Germany.
FAU - Kruger, Renate
AU  - Kruger R
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Department of Pediatric Pulmonology and Immunology, Charite Universitatsmedizin
      Berlin, Berlin, Germany.
FAU - Hoppe, Pia-Alice
AU  - Hoppe PA
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Department of Pediatric Pulmonology and Immunology, Charite Universitatsmedizin
      Berlin, Berlin, Germany.
FAU - Schneider-Burrus, Sylke
AU  - Schneider-Burrus S
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Department of Dermatology and Allergy, Charite Universitatsmedizin Berlin,
      Berlin, Germany.
FAU - Zuschneid, Irina
AU  - Zuschneid I
AD  - Charlottenburg-Wilmersdorf Health Department, Berlin, Germany.
FAU - Wischnewski, Nicoletta
AU  - Wischnewski N
AD  - Charlottenburg-Wilmersdorf Health Department, Berlin, Germany.
FAU - Bender, Jennifer
AU  - Bender J
AD  - Robert Koch Institute, Wernigerode, Germany.
FAU - Layer, Franziska
AU  - Layer F
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Robert Koch Institute, Wernigerode, Germany.
FAU - Niebank, Michaela
AU  - Niebank M
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine,
      Charite Universitatsmedizin, Berlin, Germany.
FAU - Scheibenbogen, Carmen
AU  - Scheibenbogen C
AD  - Institute of Medical Immunology, Charite Universitatsmedizin Berlin, Berlin,
      Germany.
FAU - Hanitsch, Leif G
AU  - Hanitsch LG
AD  - PVL Workgroup, Charite Universitatsmedizin Berlin, Berlin, Germany.
AD  - Institute of Medical Immunology, Charite Universitatsmedizin Berlin, Berlin,
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20171219
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Bacterial Toxins)
RN  - 0 (Exotoxins)
RN  - 0 (Leukocidins)
RN  - 0 (Panton-Valentine leukocidin)
SB  - IM
MH  - Alleles
MH  - Bacterial Toxins/*biosynthesis
MH  - Child, Preschool
MH  - Disease Outbreaks/*statistics & numerical data
MH  - Exotoxins/*biosynthesis
MH  - Family
MH  - Humans
MH  - Leukocidins/*biosynthesis
MH  - Likelihood Functions
MH  - Phylogeny
MH  - Pyoderma/*epidemiology/*microbiology
MH  - Social Support
MH  - Staphylococcal Infections/*epidemiology/*microbiology
MH  - Staphylococcus aureus/*physiology
PMC - PMC5736205
EDAT- 2017/12/21 06:00
MHDA- 2018/01/09 06:00
CRDT- 2017/12/21 06:00
PHST- 2017/07/11 00:00 [received]
PHST- 2017/12/05 00:00 [accepted]
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2018/01/09 06:00 [medline]
AID - 10.1371/journal.pone.0189961 [doi]
AID - PONE-D-17-15211 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 19;12(12):e0189961. doi: 10.1371/journal.pone.0189961.
      eCollection 2017.