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Methicillin resistance is not a predictor of severity in community-acquired Staphylococcus aureus necrotizing

N Sicot1, N Khanafer, V Meyssonnier

  • 1National Reference Centre for Staphylococci INSERM U851, Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|December 15, 2012
PubMed

Insights

Methicillin resistance does not impact the severity of staphylococcal necrotizing pneumonia (NP), a severe disease caused by Panton-Valentine leucocidin (PVL)-positive Staphylococcus aureus. This finding holds true regardless of whether the bacteria are methicillin-susceptible (MSSA) or methicillin-resistant (MRSA).

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pulmonology

Background:

  • Staphylococcal necrotizing pneumonia (NP) is a severe lung infection linked to Panton-Valentine leucocidin (PVL).
  • While initially described in methicillin-susceptible S. aureus (MSSA), cases involving methicillin-resistant S. aureus (MRSA) have increased globally.
  • The impact of methicillin resistance on NP severity remains debated.

Purpose of the Study:

  • To compare the characteristics and outcomes of patients with PVL-positive S. aureus community-acquired pneumonia (CAP) based on methicillin resistance.
  • To investigate whether methicillin resistance influences the severity and lethality of staphylococcal NP.

Main Methods:

  • Retrospective analysis of 133 patients with PVL-positive S. aureus CAP hospitalized in France (1986-2010).
  • Data collected by the National Reference Centre for Staphylococci.
  • Comparison between PVL-MRSA (29 cases) and PVL-MSSA (104 cases) pneumonia using multivariate logistic modeling and Cox regression analysis.

Main Results:

  • Airway hemorrhages were more common in PVL-MSSA pneumonia.
  • No significant differences were observed in initial severity or patient management between PVL-MRSA and PVL-MSSA groups.
  • The overall mortality rate was 39% and was not significantly influenced by methicillin resistance.

Conclusions:

  • Methicillin resistance is not a significant independent predictor of mortality in staphylococcal NP.
  • The severity of staphylococcal necrotizing pneumonia is not associated with methicillin resistance.

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