Nekrotisierende Pneumonie mit Staphylococcus aureus (pvl-Gen positiv)

Hörnig-Franz, I; Kahl, Barbara C.; Tebbe, W.; Kersting, Christian; Bürger, Horst; Nolte, K.; Becker, Karsten; Bulla, M; Debus, O.; Rabe, H.; Harms, Ernst

doi:10.1007/s00112-005-1105-6

Monatsschr Kinderheilkd

2007

DOI: 10.1007/s00112-005-1105-6

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Nekrotisierende Pneumonie mit Staphylococcus aureus (pvl-Gen positiv)

I Hörnig-Franz

Barbara C. Kahl

W. Tebbe

et al.

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Cited by 4 publications

References 7 publications

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Hautinfektionen durch MRSA

Becker

Sunderkötter

2012

Hautarzt

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Staphylococcus aureus is the most prevalent pathogen in dermatology causing a broad array of pyogenic, community-acquired (CA) and health care-associated (HA), acute and chronic, superficial and deep skin infections which can progress to life-threatening systemic infections. The pathogen causes also toxin-mediated diseases with cutaneous symptoms. Methicillin-resistant S. aureus (MRSA) strains are not sensitive to the beta-lactam antibiotics available in Germany. Even though they cause the same skin infections as methicillin -sensitive strains, they are associated with greater morbidity and mortality because of their resistance to therapy. In addition to HA-MSRA in hospitalized patients with well-known and defined risk factors, there are new CA-MSRA strains which arise in the community or from, animal husbandry sources. These MSRA strains are also a problem in hospitals today. CA-MRSA strains often have special virulence factors, such as Panton Valentine leukocidin), and are often associated with specific often recurrent skin and soft tissue infections (furuncles, abscesses, necrotizing entities).

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Hautinfektionen durch MRSA

Becker

Sunderkötter

2012

Hautarzt

Self Cite

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Chronisch rezidivierende Infektionen der Haut und Weichgewebe durch Staphylococcus aureus

et al. 2014

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Staphylococcus aureus is one of the major pathogens causing chronic skin and soft tissue infections. Particularly isolates producing Panton-Valentine leukocidin (PVL) comprising methicillin-susceptible and community-associated methicillin-resistant S. aureus (CA-MRSA) have been associated with more aggressive and persistent or relapsing courses. Beyond classical resistance mechanisms, functional resistance as shown by the small colony-variant (SCV) phenotype could be also responsible for treatment failures, despite the administration of antibiotics tested in vitro as susceptible. Also this phenotype has been associated with chronic courses of infections often with multiple exacerbations. Due to their ability to persist intracellularly, SCVs are protected from host defense and antibiotic treatment if only extracellularly active agents are administered. Reduced growth, abnormal colony morphology and changes in the metabolism of the SCVs aggravate drastically their identification, differentiation and susceptibility testing. The diagnostic and therapeutic challenges of PVL-positive and SCV isolates necessitate close collaboration with microbiological and infectious disease specialists.

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

Kreienbuehl

Charbonney

Eggimann

2011

Ann. Intensive Care

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BackgroundCommunity-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.MethodsWe 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.ResultsA 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.ConclusionsInfluenza-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.

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Nekrotisierende Pneumonie mit Staphylococcus aureus (pvl-Gen positiv)

Cited by 4 publications

References 7 publications

Hautinfektionen durch MRSA

Hautinfektionen durch MRSA

Chronisch rezidivierende Infektionen der Haut und Weichgewebe durch Staphylococcus aureus

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

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