Clinical XXXX isolates from skin and soft tissue infections show increased in  vitro production of @entity3971 soluble modulins.

@entity3256 @entity794 @entity3971 @entity2489 @entity884
BACKGROUND: @entity3971 -soluble modulins (PSMs) are amphipathic, pro-inflammatory proteins secreted by most @entity794 isolates. This study tested the hypothesis that in  vitro PSM production levels are associated with specific clinical phenotypes. METHODS: 177 @entity3256 -resistant @entity794 ( @entity794 ) isolates from @entity884 ( @entity884 ), skin and soft tissue infection (SSTI), and @entity2489 ( @entity2489 ) were matched by geographic origin, then genotyped using spa-typing. In  vitro PSM production was measured by high performance liquid chromatography/mass spectrometry. Statistical analysis was performed using Chi-squared or Kruskal-Wallis tests as appropriate. RESULTS: Spa type 1 was significantly more common in SSTI isolates (62.7% SSTI; 1.7% @entity884 ; 16.9% @entity2489 ; p  <  0.0001) while @entity2489 and @entity884 isolates were more commonly spa type 2 (0% SSTI; 37.3% @entity884 ; 40.7% @entity2489 ; p  <  0.0001). USA300 isolates produced the highest levels of PSMs in  vitro. SSTI isolates produced significantly higher quantities of PSMa1-4, PSMb1, and   -toxin than other isolates (p  <  0.001). These findings persisted when USA300 isolates were excluded from analysis. CONCLUSIONS: Increased in  vitro production of PSMs is associated with an SSTI clinical source. This significant association persisted after exclusion of USA300 genotype isolates from analysis, suggesting that PSMs play a particularly important role in the pathogenesis of SSTI as compared to other infection types.
