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留尼汪岛金黄色酿脓葡萄球菌致肺炎回顾性研究

Retrospective study of pneumonia due to Panton-Valentine leukocidin-producing Staphylococcus aureus in Reunion.

机构信息

Service des urgences-SMUR du centre hospitalier Gabriel Martin, 38, rue Labourdonnais CS 11045, 97166 Saint-Paul, Reunion; Centre René Labusquière, (Institut de Médecine tropicale), Université Victor Segalen, 33000 Bordeaux, France.

Service des urgences-SMUR du centre hospitalier Gabriel Martin, 38, rue Labourdonnais CS 11045, 97166 Saint-Paul, Reunion.

出版信息

Med Mal Infect. 2019 Oct;49(7):534-539. doi: 10.1016/j.medmal.2019.01.010. Epub 2019 Feb 11.

Abstract

OBJECTIVE

Panton-Valentine leukocidin-producing Staphylococcus aureus necrotizing pneumonia is an unusual cause of community-acquired pneumonia, although associated with a high case fatality. This infection mainly affects young individuals, without any history, and is most often preceded by flu-like symptoms.

METHOD

We focused on patients presenting with Staphylococcus aureus necrotizing pneumonia in Reunion (Indian Ocean) admitted to the emergency department. We performed a retrospective study based on data collected from laboratory registers and medical files of patients presenting with Staphylococcus aureus necrotizing pneumonia in Reunion between December 2014 and December 2017.

RESULTS

A total of 16 patients were recruited for this study, with a median age of 40.5 years. More than half of patients had previously been admitted to the emergency department for acute respiratory distress syndrome or severe sepsis. Fourteen patients were admitted to the intensive care unit and six patients died (five premature deaths).

CONCLUSION

Physicians should be aware of this infection during the flu season and quickly adapt the specific antibiotic treatment, including a drug inhibiting toxin production. As methicillin-resistant Staphylococcus aureus is very rarely observed in Reunion, physicians can still adapt the empirical treatment, without glycopeptides.

摘要

目的

产 Panton-Valentine 白细胞毒素的金黄色葡萄球菌坏死性肺炎是一种不常见的社区获得性肺炎病因,尽管其病死率很高。这种感染主要影响没有任何病史的年轻人,通常在流感样症状之前发生。

方法

我们关注的是在印度洋留尼汪岛因金黄色葡萄球菌坏死性肺炎而到急诊科就诊的患者。我们对 2014 年 12 月至 2017 年 12 月期间留尼汪岛因金黄色葡萄球菌坏死性肺炎而就诊的患者进行了一项回顾性研究,该研究基于从实验室登记册和患者病历中收集的数据。

结果

共有 16 名患者被纳入本研究,中位年龄为 40.5 岁。超过一半的患者曾因急性呼吸窘迫综合征或严重败血症而被紧急送往急诊科。14 名患者被收住重症监护病房,6 名患者死亡(5 例过早死亡)。

结论

在流感季节,医生应注意这种感染,并迅速调整特定的抗生素治疗,包括抑制毒素产生的药物。由于留尼汪岛很少观察到耐甲氧西林金黄色葡萄球菌,医生仍然可以在不使用糖肽的情况下调整经验性治疗。

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