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 communityassociated 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.S taphylococcus aureus is an infrequent cause of commu- nity-acquired pneumonia (CAP), accounting for ≈3% of cases in which a bacterial cause is identified, but it is a recognized cause of influenza-associated CAP (1-4).Methicillin-resistant S. aureus (MRSA) commonly causes nosocomial pneumonia, but relatively few cases of MRSA CAP have been reported (5,6).Recent reports have shown that MRSA is an emerging cause of skin and soft tissue disease among otherwise healthy persons who have little or no contact with healthcare settings (7,8).These…
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