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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
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Fatal cases of Staphylococcus aureus pleural empyema in infants

Anne-Laure Rougemont1, Chantal Buteau, Philippe Ovetchkine

  • 1Department of Pathology, CHU Sainte-Justine, 3175 chemin de la Côte-Ste-Catherine, Montréal, Quebec, Canada.

Pediatric and Developmental Pathology : the Official Journal of the Society for Pediatric Pathology and the Paediatric Pathology Society
|February 6, 2009
PubMed

Insights

Severe Staphylococcus aureus infections, particularly Panton-Valentine leukocidin (PVL)-positive strains, are rising in children. These PVL-positive S. aureus infections, even without methicillin resistance, warrant mandatory public health reporting due to their lethality.

Area of Science:

  • Infectious Diseases
  • Pediatric Pathology
  • Microbiology

Background:

  • Community-associated Staphylococcus aureus infections, including pleural empyema, are increasing globally.
  • The Panton-Valentine leukocidin (PVL) gene is a key virulence factor in S. aureus, particularly associated with severe pediatric necrotizing pneumonia.

Observation:

  • Two infant deaths from severe respiratory distress and bronchopneumonia with pleural empyema were investigated.
  • Both cases, occurring in the same urban area during winter, involved methicillin-sensitive S. aureus (MSSA) isolates positive for the PVL gene.
  • A third similar case with sudden death and comparable pathological findings was observed.

Findings:

  • PVL-positive MSSA was identified in fatal pediatric cases presenting with severe respiratory illness and empyema.
  • Pathological findings included bronchopneumonia and significant pleural empyema.
  • Microbiological confirmation was challenging in one case due to prior antibiotic treatment.

Implications:

  • Recognizing PVL-positive S. aureus infections in young children is crucial for timely diagnosis and management.
  • Lethal infections caused by PVL-positive S. aureus, regardless of methicillin resistance, should be mandatorily reported to public health authorities.
  • This highlights the significant public health threat posed by PVL-producing S. aureus strains in pediatric populations.

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