Journal Article

Emergence of community-acquired meticillin-resistant Staphylococcus aureus strain USA300 as a cause of necrotising community-onset pneumonia

Honig, Eric G, Low, Cari E, Blumberg, Henry M, Hidron, Alicia I

2009

Overview

Meticillin-resistant Staphylococcus aureus (MRSA), usually known as a nosocomial pathogen, has emerged as the predominant cause of skin and soft-tissue infections in many communities. Concurrent with the emergence of community-acquired MRSA (CA-MRSA), there have been increasing numbers of reports of community-acquired necrotising pneumonia in young patients and others without the classic health-care-associated risk factors. Community-onset necrotising pneumonia due to CA-MRSA is now recognised as an emerging clinical entity with distinctive clinical features and substantial morbidity and mortality. A viral prodrome (eg, influenza or influenza-like illness) followed by acute onset of shortness of breath, sepsis, and haemoptysis is the most frequent clinical presentation. The best treatment of this partly toxin-mediated disease has not been clearly defined. Whereas cases of CA-MRSA pneumonia have now been reported from almost every continent, the overall burden of disease of this emerging syndrome remains incompletely described. We report two related cases of community-onset pneumonia due to the MRSA USA300 genotype and review the literature regarding the emergence of CA-MRSA pneumonia.

• Publisher: Elsevier Ltd,Lancet Publishing Group,Elsevier Limited
• Subject: Adult / Anti-Bacterial Agents - therapeutic use / Antibacterial agents / Antibiotics. Antiinfectious agents. Antiparasitic agents / Bacterial diseases / Bacterial Proteins - genetics / Bacterial Toxins - genetics / Biological and medical sciences / Clindamycin - therapeutic use / Communicable Diseases, Emerging - drug therapy / Communicable Diseases, Emerging - microbiology / Communicable Diseases, Emerging - physiopathology / Community-Acquired Infections - drug therapy / Community-Acquired Infections - microbiology / Community-Acquired Infections - physiopathology / Drug Resistance, Multiple, Bacterial - genetics / Exotoxins - genetics / Female / Genotype / Human bacterial diseases / Humans / Infectious Disease / Infectious diseases / Intubation, Intratracheal / Leukocidins - genetics / Male / Medical sciences / Methicillin-Resistant Staphylococcus aureus - genetics / Methicillin-Resistant Staphylococcus aureus - isolation & purification / Middle Aged / Nosocomial infection / Penicillin-Binding Proteins / Pharmacology. Drug treatments / Pneumology / Pneumonia, Staphylococcal - drug therapy / Pneumonia, Staphylococcal - microbiology / Pneumonia, Staphylococcal - physiopathology / Public health / Respiratory system : syndromes and miscellaneous diseases / Risk factors / Staphylococcal infections, streptococcal infections, pneumococcal infections / Toxins / United States / Virulence Factors