Department of Emergency Medicine, Alameda County Medical Center, Oakland, California 94602, USA.
Am J Crit Care. 2013 Jul;22(4):364-7. doi: 10.4037/ajcc2013644.
Community-associated methicillin-resistant Staphylococcus aureus is a frequent cause of skin and soft-tissue infections and is increasingly identified as a cause of pneumonia in immunocompetent patients. Panton-Valentine leukocidin, one of several leukocytotoxic peptides secreted by these cocci, is associated with increased virulence. A cluster of 3 unrelated patients with fatal pneumonia presumably caused by community-associated methicillin-resistant S aureus positive for Panton-Valentine leukocidin were treated in a 3-week period. Despite aggressive care and appropriate, timely administration of antibiotics, all 3 patients died. This article reviews the clinical and laboratory features suggestive of this lethal isolate, including unique findings on Gram stains of sputum.
社区相关性耐甲氧西林金黄色葡萄球菌是皮肤和软组织感染的常见病因，并且越来越多地被认为是免疫功能正常患者肺炎的病因。杀白细胞素是这些球菌分泌的几种白细胞毒素之一，与增加的毒力有关。在 3 周的时间内，治疗了 3 例由社区相关性耐甲氧西林金黄色葡萄球菌引起的致命性肺炎的无关患者，这些患者均携带杀白细胞素。尽管进行了积极的治疗和适当、及时的抗生素治疗，但所有 3 例患者均死亡。本文回顾了提示这种致命分离株的临床和实验室特征，包括痰液革兰染色的独特发现。
