Emerging ST121/agr4 community-associated methicillin-resistant Staphylococcus aureus (MRSA) with strong adhesin and cytolytic activities: trigger for MRSA pneumonia and fatal aspiration pneumonia in an influenza-infected elderly

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• 作者：T.-W. Wan¹ ; ² ; ⁶ ; Y. Tomita³ ; ⁶ ; N. Saita⁴ ; K. Konno⁴ ; Y. Iwao¹ ; W.-C. Hung⁵ ; L.-J. Teng² ; T. Yamamoto¹ ; ^{tatsuoy@imerc.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Community-associated methicillin-resistant Staphylococcus aureus ; elderly community-acquired pneumonia ; fatal aspiration pneumonia ; influenza ; ST121/agr4 lineage
• 刊名：New Microbes and New Infections
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：13
• 期：Complete
• 页码：17-21
• 全文大小：432 K

文摘

The pathogenesis of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) pneumonia in influenza-infected elderly individuals has not yet been elucidated in detail. In the present study, a 92-year-old man infected with influenza developed CA-MRSA pneumonia. His CA-MRSA was an emerging type, originated in ST121/agr4 S. aureus, with diversities of Panton–Valentine leucocidin (PVL)⁻/spat5110/SCCmecV⁺ versus PVL⁺/spat159^(etc.)/SCCmec⁻, but with common virulence potentials of strong adhesin and cytolytic activities. Resistance to erythromycin/clindamycin (inducible-type) and gentamicin was detected. Pneumonia improved with the administration of levofloxacin, but with the subsequent development of fatal aspiration pneumonia. Hence, characteristic CA-MRSA with strong adhesin and cytolytic activities triggered influenza-related sequential complications.