Severe community-acquired pneumonia due to Staphylococcus aureus, 2003-04 influenza season

Emerg Infect Dis. 2006 Jun;12(6):894-9. doi: 10.3201/eid1206.051141.

Abstract

During the 2003-04 influenza season, 17 cases of Staphylococcus aureus community-acquired pneumonia (CAP) were reported from 9 states; 15 (88%) were associated with methicillin-resistant S. aureus (MRSA). The median age of patients was 21 years; 5 (29%) had underlying diseases, and 4 (24%) had risk factors for MRSA. Twelve (71%) had laboratory evidence of influenza virus infection. All but 1 patient, who died on arrival, were hospitalized. Death occurred in 5 (4 with MRSA). S. aureus isolates were available from 13 (76%) patients (11 MRSA). Toxin genes were detected in all isolates; 11 (85%) had only genes for Panton-Valentine leukocidin. All isolates had community-associated pulsed-field gel electrophoresis patterns; all MRSA isolates had the staphylococcal cassette chromosome mec type IVa. In communities with a high prevalence of MRSA, empiric therapy of severe CAP during periods of high influenza activity should include consideration for MRSA.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Community-Acquired Infections / microbiology*
  • Community-Acquired Infections / virology
  • DNA, Bacterial / chemistry
  • DNA, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Genotype
  • Humans
  • Infant
  • Influenza, Human / immunology
  • Influenza, Human / microbiology*
  • Influenza, Human / virology
  • Male
  • Methicillin Resistance
  • Microbial Sensitivity Tests
  • Middle Aged
  • Orthomyxoviridae*
  • Pneumonia, Bacterial / microbiology*
  • Pneumonia, Bacterial / virology
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / virology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification*

Substances

  • DNA, Bacterial