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

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Authors

RÁJOVÁ Jana PANTŮČEK Roman PETRÁŠ Petr VARBANOVOVÁ Ivana MAŠLAŇOVÁ Ivana BENEŠ Jiří

Year of publication 2016
Type Article in Periodical
Magazine / Source Epidemiology & Infection
MU Faculty or unit

Faculty of Science

Citation
Web http://dx.doi.org/10.1017/S0950268815001521
Doi http://dx.doi.org/10.1017/S0950268815001521
Field Microbiology, virology
Keywords Community-acquired pneumonia; necrotizing pneumonia; Panton–Valentine leukocidin; septic shock; Staphylococcus aureus
Attached files
Description 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.
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