Community-acquired necrotizing pneumonia due to methicillin-sensitive Staphylococcus aureus secreting Panton-Valentine leukocidin: a review of case reports

Annals of Intensive Care - Tập 1 - Trang 1-7 - 2011
Lukas Kreienbuehl1, Emmanuel Charbonney2, Philippe Eggimann3
1Department of Anaesthesiology, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
2Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
3Department of Intensive Care, Centre Hospitalier Universitaire Vaudois (CHUV), and University of Lausanne, Switzerland

Tóm tắt

Community-acquired necrotizing pneumonia caused by Panton-Valentine leukocidin (PVL)-secreting Staphylococcus aureus is a highly lethal infection that mainly affects healthy children and young adults. Both methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) may carry the PVL-phage, but the majority of publications relate to community-associated methicillin-resistant S. aureus (CA-MRSA) or mixed patient groups. This study focuses on necrotizing pneumonia due to methicillin-sensitive S. aureus strains, with the purpose to determine factors associated with outcome. We report a patient with PVL secreting MSSA necrotizing pneumonia and performed a systematic review of similar case in the literature. We analyzed factors associated with outcome. A total of 32 patient descriptions were retained for analysis. Septic shock (p = 0.007), influenza-like prodrome (p = 0.02), and the absence of a previous skin and soft-tissue infection (p = 0.024) were associated with fatal outcome. In multivariate analysis, influenza-like prodrome (odds ratio (OR), 7.44; 95% confidence interval (CI), 1.24-44.76; p = 0.028) and absence of previous skin and soft-tissue infection (OR, 0.09; 95% CI, 0.01-0.86; p = 0.036) remained significant predictors of death. Influenza-like prodrome may be predictive of adverse outcome in PVL-secreting MSSA necrotizing pneumonia. In contrast, previous skin and soft-tissue infection may be associated with improved prognosis.

Tài liệu tham khảo

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