Severe community-acquired pneumonia due to Staphylococcus aureus, 2003-04 influenza season.
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.
Hageman
Jeffrey C
JC
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. JHageman@cdc.gov
Uyeki
Timothy M
TM
Francis
John S
JS
Jernigan
Daniel B
DB
Wheeler
J Gary
JG
Bridges
Carolyn B
CB
Barenkamp
Stephen J
SJ
Sievert
Dawn M
DM
Srinivasan
Arjun
A
Doherty
Meg C
MC
McDougal
Linda K
LK
Killgore
George E
GE
Lopatin
Uri A
UA
Coffman
Rebecca
R
MacDonald
J Kathryn
JK
McAllister
Sigrid K
SK
Fosheim
Gregory E
GE
Patel
Jean B
JB
McDonald
L Clifford
LC
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*
D004269:DNA, Bacterial