Disseminated sepsis due to a Panton-Valentine leukocidin producing strain of community acquired meticillin resistant Staphylococcus aureus and use of intravenous immunoglobulin therapy

Hampson, FG

doi:10.1136/adc.2005.075028

Cited by 29 publications

(19 citation statements)

References 6 publications

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“…Ninety-two cases of severe S. aureus CAP were reported in 70 articles during the period from 1995 to 2009 from North America (35 cases, 38.0%) [2,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42], Europe (40 cases, 43.5%) [1,7,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74], Asia (11 cases, 12.0%) [75,76,77,78,79,80,81,82], and Australia (6 cases, 6.5%) [83,84,85,86,87,88] (table 1). Data on outcomes were available for 91 patients.…”

Section: Resultsmentioning

confidence: 99%

Factors Associated with the Outcome of Life-Threatening Necrotizing Pneumonia due to Community-Acquired <i>Staphylococcus aureus</i> in Adult and Adolescent Patients

Zhang²,

Huang³

et al. 2010

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Background: Although community-acquired Staphylococcus aureus pneumonia with highly virulent Panton-Valentine leukocidin (PVL)-positive strains, a severe disease with significant lethality, is rare, especially in adult and adolescent patients, recent reports highlight that these infections are on the rise. Objectives: To describe the demographic and clinical features of reported cases of life-threatening community-acquired S. aureus pneumonia with usually PVL-positive strains in adult and adolescent patients, to evaluate the variables related to death, and to select a more appropriate antimicrobial treatment for this potentially deadly disease. Methods: We summarized all of the 92 reported cases and our case. The effect of 5 variables on mortality was measured using logistic regression. Results:S. aureus community-acquired pneumonia (CAP) with usually PVL-positive strains is a severe disease with significant lethality, i.e. 42.9%; a short duration of the time from the onset of symptoms to death, i.e. 5.5 ± 10.1 days, and prolonged hospital admissions, i.e. 33.2 ± 29.5 days. Seventy-three cases have been tested for the gene for PVL, and 71 strains have been found to carry the PVL gene. Logistic regression analysis showed that leucopenia (p = 0.002), influenza-like symptoms or laboratory-confirmed influenza (p = 0.011), and hemoptysis (p = 0.024) were the factors associated with death. Antibiotic therapies inhibiting toxin production were associated with an improved outcome in these cases (p = 0.007). Conclusions: Physicians should pay special attention to those patients who acquired severe CAP during influenza season and have flu-like symptoms, hemoptysis, and leucopenia, and they should consider S. aureus more frequently among the possible pathogens of severe CAP. Empiric therapy for severe CAP with this distinct clinical picture should include coverage for S. aureus. Targeted treatment with antimicrobials inhibiting toxin production appears to be a more appropriate selection.

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Section: Resultsmentioning

confidence: 99%

Factors Associated with the Outcome of Life-Threatening Necrotizing Pneumonia due to Community-Acquired <i>Staphylococcus aureus</i> in Adult and Adolescent Patients

Zhang²,

Huang³

et al. 2010

Respiration

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“…There are no data on treatment with antitoxin antibiotics. In cases of multiple abscesses that are not surgically accessible and that are progressing despite appropriate antibiotics, two published cases report a dramatic improvement after treatment with IVIg [42,57].…”

Section: Complicated Skin and Soft-tissue Infectionsmentioning

confidence: 99%

Pragmatic management of Panton–Valentine leukocidin-associated staphylococcal diseases

Gillet

Dumitrescu

Tristan

et al. 2011

International Journal of Antimicrobial Agents

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Panton-Valentine leukocidin (PVL)-producing Staphylococcus aureus is associatedwith a broad spectrum of diseases, ranging from common uncomplicated soft tissue infections to severe diseases such as complicated soft tissue infections, extensive bone and joint infections, and necrotizing pneumonia. Specialised management of infection based on the presence of PVL may not be required for mild infections, whereas it could be lifesaving in other settings. Moreover, most severe PVL diseases are recently identified entities and a 'gold standard' treatment from comparatives studies of different therapeutic options is lacking. Thus, recommendations are based on expert opinions, which are elaborated based on theory, in vitro data and analogies with other toxin-mediated diseases. In this review, we consider the potential need for specialised PVL-based management and, if required, which tools should be used to achieve optimal management.

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“…One case report (360) and one in vitro study (314) suggested that intravenous immunoglobulin (IVIG) may be an effective adjunctive therapy for sepsis caused by PVL ϩ CA-MRSA, but further study is needed to validate this observation (658). Infectious foci should be drained, and necrotic tissue should be debrided when feasible (7,87,159,224,379,523,525,609,1021).…”

Section: Severe Infectionsmentioning

confidence: 99%

Community-Associated Methicillin-ResistantStaphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic

2010

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SUMMARY Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.

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Disseminated sepsis due to a Panton-Valentine leukocidin producing strain of community acquired meticillin resistant Staphylococcus aureus and use of intravenous immunoglobulin therapy

Cited by 29 publications

References 6 publications

Factors Associated with the Outcome of Life-Threatening Necrotizing Pneumonia due to Community-Acquired <i>Staphylococcus aureus</i> in Adult and Adolescent Patients

Factors Associated with the Outcome of Life-Threatening Necrotizing Pneumonia due to Community-Acquired <i>Staphylococcus aureus</i> in Adult and Adolescent Patients

Pragmatic management of Panton–Valentine leukocidin-associated staphylococcal diseases

Community-Associated Methicillin-ResistantStaphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic

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