Necrotizing pneumonia due to clonally diverse Staphylococcus aureus strains producing Panton-Valentine leukocidin: the Czech experience

Abstract

A prospective study (2007-2013) was undertaken to investigate clinical features and prognostic factors of necrotizing pneumonia caused by Staphylococcus aureus producing Panton-Valentine leukocidin (PVL) in the Czech Republic. Twelve cases of necrotizing pneumonia were detected in 12 patients (median age 25 years) without severe underlying disease. Eight cases occurred in December and January and the accumulation of cases in the winter months preceding the influenza season was statistically significant (P < 0·001). The course of pneumonia was very rapid, leading to early sepsis and/or septic shock in all but one patient. Seven patients died and mortality was fourfold higher in those patients presenting with primary pneumonia than with pneumonia complicating other staphylococcal/pyogenic infection elsewhere in the body. The S. aureus isolates displayed considerable genetic variability and were assigned to five lineages CC8 (n = 3), CC15 (n = 2), CC30 (n = 2), CC80 (n = 1), and CC121 (n = 3) and one was a singleton of ST154 (n = 1), all were reported to be associated with community-acquired infection. Four strains were methicillin resistant. The high case-fatality rate can only be reduced by improving the speed of diagnosis and a rapid test to detect S. aureus in the airways is needed.

<p>Community-associated <em>Staphylococcus aureus</em> PVL⁺ ST22 predominates in skin and soft tissue infections in Beijing, China</p>

“…Panton–Valentine leukocidin (PVL), for instance, is a key virulence factor. Previous studies have shown the association between PVL and severe invasive infections 9,10. Thus, it is important to characterize the virulence factors of CA- S. aureus for improving therapeutic approaches.…”

Molecular characterization of methicillin-resistant <em>Staphylococcus aureus</em> isolated from the pig production chain in Northern Italy

“…Furthermore, an isolate belonging to ST30/t318 was reported for the first time in Italian pig farms with this work, although ST30 carrying other spa-types (i.e., t012 and t093) were isolated from swabs collected in slaughterhouses located in Southern Italy (Normanno et al, 2015). Isolates belonging to ST30 have been described as CA-MRSA; in particular, ST30/t318 has been reported to be responsible for abscesses, bloodstream or necrotic infections in different parts of the world (e.g., Czech Republic, China) (Jiang et al, 2013;Rájová et al, 2016), and the presence of an isolate collected from farm belonging to this lineage is of concern for the health of people coming into contact with animals.…”

“…Isolates belonging to ST30 have been described as CA-MRSA; in particular, ST30/t318 has been reported to be responsible for abscesses, bloodstream or necrotic infections in different parts of the world ( e.g. , Czech Republic, China) (Jiang et al , 2013 ; Rájová et al , 2016 ), and the presence of an isolate collected from farm belonging to this lineage is of concern for the health of people coming into contact with animals. Finally, the molecular characterization allowed to identify an isolate belonging to a novel ST, further characterized as ST5422, showing spa -type t1730.…”

Draft Genome Sequence of the Panton-Valentine Leucocidin-Producing Staphylococcus aureus Sequence Type 154 Strain NRL 08/001, Isolated from a Fatal Case of Necrotizing Pneumonia

“…S. aureus strain NRL 08/001 (=CNCTC 7452), belonging to sequence type 154 (ST154) and spa type t667 (3), was isolated from a fatal case of pneumonia in a 22-year-old patient in 2007 in the Czech Republic (4). Only a few PVL-positive ST154 strains have been reported in western Europe (5–7) and Japan (8), but wide distribution of this clone was found in Mongolia (9).…”