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产杀白细胞素的感染:病例系列

Panton-Valentine Leukocidin-Producing Infection: A Case Series.

作者信息

Prista-Leão Beatriz, Abreu Isabel, Duro Raquel, Silva-Pinto André, Ceia Filipa, Andrade Paulo, Sobrinho-Simões Joana, Tavares Margarida, Pereira José Manuel, Santos Lurdes, Sarmento António

机构信息

Department of Infectious Diseases, Centro Hospitalar Universitário de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.

Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal.

出版信息

Infect Dis Rep. 2020 Nov 3;12(3):61-69. doi: 10.3390/idr12030014.

Abstract

Panton-Valentine leukocidin-producing (PVL-SA) is associated with relapsing multifocal skin and soft tissue infections (SSTI), necrotizing pneumonia (NP) and severe musculoskeletal infections. Epidemiology is underknown and underdiagnosis is likely. Recent travel abroad, case clustering and relapsing disease are often reported. We reviewed all cases of PVL-SA infection diagnosed at our center, and found 21 cases over a 43-month period. Most patients were adult males, had relevant travel history, reported recurrent disease and presented with SSTI. Etiologic diagnosis took up to five years; meanwhile, 42% of patients had antibiotic treatments. Draining procedures were required in 43% of patients and intensive care support in 19%. All patients recovered. Methicillin-resistance prevalence was 24%. Only 2/13 decolonized patients had posterior relapsing SSTI, both with likely infected contacts. PVL-SA infection's severity and impact are clear, even in small case series as ours. Physician awareness and active PVL-gene search are crucial for an adequate management.

摘要

产杀白细胞素的泛耐药金黄色葡萄球菌(PVL-SA)与复发性多灶性皮肤和软组织感染(SSTI)、坏死性肺炎(NP)及严重肌肉骨骼感染相关。其流行病学情况尚不明确,漏诊情况可能较多。近期国外旅行史、病例聚集及疾病复发的情况常有报道。我们回顾了在本中心诊断的所有PVL-SA感染病例,发现在43个月期间共有21例。大多数患者为成年男性,有相关旅行史,疾病复发,表现为SSTI。病因诊断耗时长达5年;同时,42%的患者接受了抗生素治疗。43%的患者需要进行引流操作,19%的患者需要重症监护支持。所有患者均康复。耐甲氧西林率为24%。13例去定植患者中只有2例出现SSTI复发,二者均可能有感染源接触史。即使在像我们这样的小病例系列中,PVL-SA感染的严重性和影响也很明显。医生的认识以及积极的PVL基因检测对于恰当的管理至关重要。

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