Department of Laboratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
Department of Respiratory Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
J Infect Chemother. 2022 Sep;28(9):1329-1331. doi: 10.1016/j.jiac.2022.05.011. Epub 2022 May 30.
Staphylococcus aureus (S. aureus) sequence type 398 (ST398) has aroused great concern for its spread throughout the world. ST398 community-acquired MRSA (CA-MRSA) has been given greater emphasis because of its high virulence and high probability of treatment failure. Herein, A 22-year-old male was admitted to our hospital with a history of fever, chest pain and dyspnea for 2 days. A chest CT scan showed infiltrative and nodular shadows. The sequence type of the isolates from blood culture was ST398, the virulence genes detected was PVL gene (lukS-PV and lukF-PV). Despite resuscitation efforts, he died of multiple organ failure on admission 3rd day. This is the first described case of severe pneumonia and sepsis due to hematogenous spread of scalp furuncles caused by Panton-Valentine leukocidin (PVL) positive community-acquired methicillin-susceptible S. aureus (CA-MSSA) ST398 strains in an immunocompentent adult in mainland China. This report highlight the emergence CA-PVL-MSSA ST398 infection and its association with life-threatening infections. Early decolonization and identification of ST398 is critical. Severe skin and soft tissue infections should be suspected for ST398 PVL-MSSA.
金黄色葡萄球菌（S. aureus）序列型 398（ST398）在全球范围内的传播引起了极大关注。由于其高毒力和治疗失败的可能性较高，ST398 社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）受到了更多的重视。在此，我们报告了 1 例由头皮疖引起的血流播散、Panton-Valentine 白细胞毒素（PVL）阳性、社区获得性耐甲氧西林金黄色葡萄球菌（CA-MSSA）ST398 菌株引起的严重肺炎和败血症的病例。患者为 22 岁男性，发热、胸痛和呼吸困难 2 天入院。胸部 CT 扫描显示浸润性和结节状阴影。血培养分离株的序列型为 ST398，检测到的毒力基因是 PVL 基因（lukS-PV 和 lukF-PV）。尽管进行了复苏治疗，但他在入院第 3 天因多器官功能衰竭死亡。这是首例在中国大陆免疫功能正常的成人中，由 PVL 阳性 CA-MSSA ST398 菌株引起的头皮疖源性血行播散导致严重肺炎和败血症的病例。本报告强调了 CA-PVL-MSSA ST398 感染的出现及其与危及生命感染的关联。早期去定植和 ST398 的鉴定至关重要。对于 ST398 PVL-MSSA，应怀疑严重的皮肤和软组织感染。
