Panton-Valentine leukocidin-producing Staphylococcus aureus infections: Report of 4 French cases

Salliot, Carine; Zeller, Valérie; Puéchal, Xavier; Manceron, V.; Sire, Stéphane; Varache, N.; Étienne, Jérôme; Desplaces, Nicole; Ziza, Jean-Marc

doi:10.1080/00365540500388776

Cited by 22 publications

(25 citation statements)

References 18 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

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“…An association between PVL-containing strains of MRSA and virulent necrotizing pneumonia mainly in previously healthy children has been reported (14,16,23). Therefore, rapidly determining PVL presence/absence in the early clinical stage may improve patient outcomes and guide proper therapy, such as immunoglobulin administration (13,32).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Patterns and Staphylococcal Cassette Chromosome mec Types of, as Well as Panton-Valentine Leukocidin Occurrence among, Methicillin-Resistant Staphylococcus aureus Isolates from Children and Adults in Middle Tennessee

Kılıç

Li²,

Stratton

et al. 2006

J Clin Microbiol

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Antimicrobial susceptibility patterns, Panton-Valentine leukocidin (PVL) occurrence, and staphylococcal cassette chromosome mec (SCCmec) types in methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from children and adults at Vanderbilt University Medical Center during a 12-month period were evaluated. A total of 1,315 MRSA isolates were collected, of which 748 (36.7%) were recovered from children. Among all isolates, 448 (34.1%) were SCCmec-II, and 847 (64.4%) were SCCmec-IV. More SCCmec-IV isolates were recovered from children than SCCmec-II isolates (424 [50.1%] versus 50 [11.2%]; odds ration [OR] ‫؍‬ 7.98; P < 0.000001). The PVL gene was detected in 93.6% of SCCmec-IV isolates, in contrast to 0.2% in SCCmec-II isolates. Within SCCmec-IV isolates, a statistically higher PVL occurrence was noticed in children (98.1%) than in adults (89.1%) (OR ‫؍‬ 6.34; P < 0.000001). Overall, SCCmec-II strains showed greater resistance than SCCmec-IV strains to clindamycin, erythromycin, levofloxacin, gentamicin, rifampin, minocycline, and trimethoprim-sulfamethoxazole. Both SCCmec-II and SCCmec-IV strains recovered from adults were more resistant to these antibiotics than those recovered from children. SCCmec-II strains were predominantly recovered from the respiratory tract, whereas SCCmec-IV strains were predominantly recovered from skin, soft tissue, abscesses, and surgical wounds. These data indicate that SCCmec-IV MRSA isolates frequently infect children in middle Tennessee and are likely to harbor the PVL gene.

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“…In Australia, the first reports of community-onset MRSA infections in 1993 were caused by strains that lacked PVL genes. Subsequently, however, a polyclonal surge of largely PVL ϩ MRSA infections occurred among previously healthy, young adults and children; each newly described PVL ϩ SCCmec type IV-bearing community strain identified in that country had a distinct geographic distribution (670 (321,765,797,851,902), although such outbreaks appear to be relatively rare.…”

Section: Pvl and Ca-mrsamentioning

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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Panton-Valentine leukocidin-producing Staphylococcus aureus infections: Report of 4 French cases

Cited by 22 publications

References 18 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

Antimicrobial Susceptibility Patterns and Staphylococcal Cassette Chromosome mec Types of, as Well as Panton-Valentine Leukocidin Occurrence among, Methicillin-Resistant Staphylococcus aureus Isolates from Children and Adults in Middle Tennessee

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

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