Emerging Infectious Diseases (Jun 2006)

Severe Community-acquired Pneumonia Due to Staphylococcus aureus, 2003–04 Influenza Season

  • Jeffrey C. Hageman,
  • Timothy M. Uyeki,
  • John S. Francis,
  • Daniel B. Jernigan,
  • J. Gary Wheeler,
  • Carolyn B. Bridges,
  • Stephen J. Barenkamp,
  • Dawn M. Sievert,
  • Arjun Srinivasan,
  • Meg C. Doherty,
  • Linda K. McDougal,
  • George E. Killgore,
  • Uri A. Lopatin,
  • Rebecca Coffman,
  • J. Kathryn MacDonald,
  • Sigrid K. McAllister,
  • Gregory E. Fosheim,
  • Jean B. Patel,
  • L. Clifford McDonald

DOI
https://doi.org/10.3201/eid1206.051141
Journal volume & issue
Vol. 12, no. 6
pp. 894 – 899

Abstract

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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.

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