Meticillin-resistant<i>Staphylococcus aureus</i>and meticillin-susceptible<i>S. aureus</i>pneumonia: comparison of clinical and thin-section CT findings

Morikawa, Keiko; Okada, Fumito; Ando, Yumiko; Ishii, Ryo; Matsushita, Shoichiro; Ono, Asami; Maeda, Takeyasu; Mori, Hiromu; Yamashita, Seizo; Kawahara, K.

doi:10.1259/bjr/65538472

Cited by 25 publications

(12 citation statements)

References 29 publications

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“…Since MSSA was rarely isolated during the antibiotic treatment of MAC in this study, some of the nodules found in patients with chronic MSSA co-infection might have been associated with MSSA pneumonia. 33 …”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for chronic co-infection in pulmonaryMycobacterium aviumcomplex disease

et al. 2014

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BackgroundPatients with pulmonary Mycobacterium avium complex (MAC) disease are often co-infected with various pathogenic microorganisms. This study aimed to determine the prevalence of co-infection with non-MAC pathogens and the risk factors associated with co-infection in patients with pulmonary MAC disease.MethodsWe retrospectively reviewed the patient characteristics, microbiological results and chest CT findings in 275 patients with pulmonary MAC who visited the Kyoto University Hospital from January 2001 to May 2013. We defined chronic pathogenic co-infection as the isolation of non-MAC pathogens from sputum samples taken on more than two visits that occurred at least 3 months apart.ResultsThe participants were predominantly female (74.5%) and infected with M. avium (75.6%). Chronic co-infection with any pathogen was observed in 124 patients (45.1%). Methicillin-sensitive Staphylococcus aureus (MSSA; n=64), Pseudomonas aeruginosa (n=35) and Aspergillus spp (n=18) were the most prevalent pathogens. The adjusted factors were chronic obstructive pulmonary disease (COPD; OR=4.2, 95% CI 1.6 to 13.1) and pulmonary M. intracellulare disease (OR=2.2, 95% CI 1.1 to 4.4) in chronic co-infections; COPD (OR=4.2, 95% CI 2.1 to 31.4), long duration of MAC disease (OR=2.2, 95% CI 1.2 to 4.4) and nodules (OR=3.5, 95% CI 1.2 to 13.2) in chronic MSSA co-infection; COPD (OR=7.5, 95% CI 2.1 to 31.4) and lower lobe involvement (OR=9.9, 95% CI 2.0 to 90.6) in chronic P. aeruginosa co-infection; and use of systemic corticosteroids (OR=7.1, 95% CI 1.2 to 50.9) and pulmonary M. intracellulare disease (OR=4.0, 95% CI 1.1 to 14.5) in chronic Aspergillus spp co-infection.ConclusionsPatients with pulmonary MAC disease frequently had chronic co-infections with pathogenic microorganisms such as MSSA, P. aeruginosa and Aspergillus. The risk factors for chronic co-infection were COPD and pulmonary M. intracellulare disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors for chronic co-infection in pulmonaryMycobacterium aviumcomplex disease

et al. 2014

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“…CT will show centrilobular nodules and bronchial wall thickening. Lung parenchymal abnormalities in the form of peripheral areas of consolidation are more frequently seen in methicillin-resistant staphylococcal bacteria [11]. Cavitation may appear in areas of consolidation, forming lung abscesses; empyema may also be encountered.…”

Section: Bacterial Pneumoniamentioning

confidence: 99%

Spectrum of imaging findings in pulmonary infections. Part 1: Bacterial and viral

Garg¹,

Prabhakar²,

Gulati³

et al. 2019

Pol J Radiol

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Chest radiography is generally the first imaging modality used for the evaluation of pneumonia. It can establish the presence of pneumonia, determine its extent and location, and assess the response to treatment. Computed tomography is not used for the initial evaluation of pneumonia, but it may be used when the response to treatment is unusually slow. It helps to identify complications, detect any underlying chronic pulmonary disease, and also to characterise complex pneumonias. Although not diagnostic, certain imaging findings may suggest a particular microbial cause over others. Knowledge of whether pneumonia is community-acquired or nosocomial, as well as the age and immune status of the patient, can help us in narrowing the differential diagnoses. The purpose of this article is to briefly review the various pulmonary imaging manifestations of pathogenic organisms. This knowledge along with clinical history and laboratory investigations of the patient may help in guiding the treatment of pneumonia.

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“…Influenza impairs host immunological mechanisms [14] , promoting the development of CA-MRSA pneumonia [14] , [16] . The present case also had influenza-related CA-MRSA CAP, with chest radiography findings showing MRSA pneumonia [17] , and was successfully treated with levofloxacin.…”

Section: Discussionmentioning

confidence: 68%

“…1 ): an infiltrative shadow in the right lung (arrow 1) and consolidation with air bronchograms on the lateral side of the left middle lung field (arrow 2). The pattern of the chest radiography findings, a peripherally distributed parenchymal abnormality (arrow 2), is more frequent with MRSA pneumonia than with MSSA pneumonia [17] . Respiratory failure (SpO 2 , 76%) was noted.…”

Section: Casementioning

confidence: 99%

Emerging ST121/ agr 4 community-associated methicillin-resistant Staphylococcus aureus (MRSA) with strong adhesin and cytolytic activities: trigger for MRSA pneumonia and fatal aspiration pneumonia in an influenza-infected elderly

Wan

Tomita

Saita³

et al. 2016

New Microbes and New Infections

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The pathogenesis of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) pneumonia in influenza-infected elderly individuals has not yet been elucidated in detail. In the present study, a 92-year-old man infected with influenza developed CA-MRSA pneumonia. His CA-MRSA was an emerging type, originated in ST121/agr4 S. aureus, with diversities of Panton–Valentine leucocidin (PVL)−/spat5110/SCCmecV+ versus PVL+/spat159(etc.)/SCCmec−, but with common virulence potentials of strong adhesin and cytolytic activities. Resistance to erythromycin/clindamycin (inducible-type) and gentamicin was detected. Pneumonia improved with the administration of levofloxacin, but with the subsequent development of fatal aspiration pneumonia. Hence, characteristic CA-MRSA with strong adhesin and cytolytic activities triggered influenza-related sequential complications.

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Meticillin-resistantStaphylococcus aureusand meticillin-susceptibleS. aureuspneumonia: comparison of clinical and thin-section CT findings

Cited by 25 publications

References 29 publications

Prevalence and risk factors for chronic co-infection in pulmonaryMycobacterium aviumcomplex disease

Prevalence and risk factors for chronic co-infection in pulmonaryMycobacterium aviumcomplex disease

Spectrum of imaging findings in pulmonary infections. Part 1: Bacterial and viral

Emerging ST121/ agr 4 community-associated methicillin-resistant Staphylococcus aureus (MRSA) with strong adhesin and cytolytic activities: trigger for MRSA pneumonia and fatal aspiration pneumonia in an influenza-infected elderly

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