title: Severe community-acquired pneumonia due to Staphylococcus aureus, 2003-04 influenza season.
abstract: During the 2003-04 influenza season, 17 cases of Staphylococcus aureus community-acquired pneumonia (CAP) were reported from 9 states; 15 (88%) were associated with methicillin-resistant S. aureus (MRSA). The median age of patients was 21 years; 5 (29%) had underlying diseases, and 4 (24%) had risk factors for MRSA. Twelve (71%) had laboratory evidence of influenza virus infection. All but 1 patient, who died on arrival, were hospitalized. Death occurred in 5 (4 with MRSA). S. aureus isolates were available from 13 (76%) patients (11 MRSA). Toxin genes were detected in all isolates; 11 (85%) had only genes for Panton-Valentine leukocidin. All isolates had community-associated pulsed-field gel electrophoresis patterns; all MRSA isolates had the staphylococcal cassette chromosome mec type IVa. In communities with a high prevalence of MRSA, empiric therapy of severe CAP during periods of high influenza activity should include consideration for MRSA.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. JHageman@cdc.gov
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Hageman
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Uyeki
authors.forename: John S
authors.initials: JS
authors.lastname: Francis
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Jernigan
authors.forename: J Gary
authors.initials: JG
authors.lastname: Wheeler
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Bridges
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Barenkamp
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Sievert
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Meg C
authors.initials: MC
authors.lastname: Doherty
authors.forename: Linda K
authors.initials: LK
authors.lastname: McDougal
authors.forename: George E
authors.initials: GE
authors.lastname: Killgore
authors.forename: Uri A
authors.initials: UA
authors.lastname: Lopatin
authors.forename: Rebecca
authors.initials: R
authors.lastname: Coffman
authors.forename: J Kathryn
authors.initials: JK
authors.lastname: MacDonald
authors.forename: Sigrid K
authors.initials: SK
authors.lastname: McAllister
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Fosheim
authors.forename: Jean B
authors.initials: JB
authors.lastname: Patel
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology* / Q000821:virology; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000276:immunology / Q000382:microbiology* / Q000821:virology; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009975:Orthomyxoviridae; D018410:Pneumonia, Bacterial / Q000382:microbiology* / Q000821:virology; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000821:virology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D004269:DNA, Bacterial