Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes

John S Francis, Meg C. Doherty, Uri Lopatin, Cecilia P. Johnston, Gita Sinha, Tracy Ross, Mian Cai, Nadia N. Hansel, Trish Perl, John R. Ticehurst, Karen Carroll, David L. Thomas, Eric Nuermberger, John G. Bartlett

Research output: Contribution to journalArticle

599 Citations (Scopus)

Abstract

Background. Recent worldwide reports of community-onset skin abscesses, outbreaks of furunculosis, and severe pneumonia associated with methicillin-resistant Staphylococcus aureus (MRSA) carrying Panton-Valentine leukocidin (PVL) genes and the staphylococcal cassette chromosome mec (SCCmec) type IV indicate that MRSA infections are evolving into a community-related problem. The majority of cases reported to date involve skin and soft-tissue infections, with severe pneumonia representing a relatively rare phenomenon. During a 2-month period in the winter of 2003-2004, four healthy adults presented to 1 of 2 Baltimore hospitals with severe necrotizing MRSA pneumonia in the absence of typical risk factors for MRSA infection. Methods. Patients' MRSA isolates were characterized by strain typing with use of pulsed-field gel electrophoresis and SCCmec typing with use of a multiplex polymerase chain reaction (PCR) assay and detection of PVL genes by PCR. Results. All 4 patients' MRSA isolates carried the PVL genes and the SCCmec type IV element and belonged to the USA300 pulsed-field type. These 3 findings are among the typical characteristics of community-onset MRSA strains. In addition, 2 of our patients had concomitant influenza A diagnosed, which likely contributed to the severity of their presentation. Conclusions. To our knowledge, these patients represent the first reported North American adults with severe community-onset MRSA pneumonia caused by strains carrying the PVL genes.

Original languageEnglish (US)
Pages (from-to)100-107
Number of pages8
JournalClinical Infectious Diseases
Volume40
Issue number1
DOIs
StatePublished - Jan 1 2005
Externally publishedYes

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Methicillin-Resistant Staphylococcus aureus
Pneumonia
Genes
Staphylococcal Pneumonia
Chromosomes
Furunculosis
Baltimore
Skin
Soft Tissue Infections
Panton-Valentine leukocidin
Pulsed Field Gel Electrophoresis
Multiplex Polymerase Chain Reaction
Infection
Abscess
Human Influenza
Disease Outbreaks
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Immunology

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Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. / Francis, John S; Doherty, Meg C.; Lopatin, Uri; Johnston, Cecilia P.; Sinha, Gita; Ross, Tracy; Cai, Mian; Hansel, Nadia N.; Perl, Trish; Ticehurst, John R.; Carroll, Karen; Thomas, David L.; Nuermberger, Eric; Bartlett, John G.

In: Clinical Infectious Diseases, Vol. 40, No. 1, 01.01.2005, p. 100-107.

Research output: Contribution to journalArticle

Francis, JS, Doherty, MC, Lopatin, U, Johnston, CP, Sinha, G, Ross, T, Cai, M, Hansel, NN, Perl, T, Ticehurst, JR, Carroll, K, Thomas, DL, Nuermberger, E & Bartlett, JG 2005, 'Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes', Clinical Infectious Diseases, vol. 40, no. 1, pp. 100-107. https://doi.org/10.1086/427148
Francis, John S ; Doherty, Meg C. ; Lopatin, Uri ; Johnston, Cecilia P. ; Sinha, Gita ; Ross, Tracy ; Cai, Mian ; Hansel, Nadia N. ; Perl, Trish ; Ticehurst, John R. ; Carroll, Karen ; Thomas, David L. ; Nuermberger, Eric ; Bartlett, John G. / Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. In: Clinical Infectious Diseases. 2005 ; Vol. 40, No. 1. pp. 100-107.
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