Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador
BACKGROUND: USA300 community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI). METHODS: A case series of necrotizing pneumonia presenting as a prim...
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ftmemorialuniv:oai:research.library.mun.ca:11991 2023-10-01T03:57:38+02:00 Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador Toro, Christina Moran Janvier, Jack Zhang, Kunyan Fonseca, Kevin Gregson, Dan Laupland, Kevin Rabin, Harvey Elsayed, Sameer Conly, John 2014 application/pdf https://research.library.mun.ca/11991/ https://research.library.mun.ca/11991/1/Hindawi27.pdf https://doi.org/10.1155/2014/952603 en eng Hindawi Publishing Corporation https://research.library.mun.ca/11991/1/Hindawi27.pdf Toro, Christina Moran <https://research.library.mun.ca/view/creator_az/Toro=3AChristina_Moran=3A=3A.html> and Janvier, Jack <https://research.library.mun.ca/view/creator_az/Janvier=3AJack=3A=3A.html> and Zhang, Kunyan <https://research.library.mun.ca/view/creator_az/Zhang=3AKunyan=3A=3A.html> and Fonseca, Kevin <https://research.library.mun.ca/view/creator_az/Fonseca=3AKevin=3A=3A.html> and Gregson, Dan <https://research.library.mun.ca/view/creator_az/Gregson=3ADan=3A=3A.html> and Laupland, Kevin <https://research.library.mun.ca/view/creator_az/Laupland=3AKevin=3A=3A.html> and Rabin, Harvey <https://research.library.mun.ca/view/creator_az/Rabin=3AHarvey=3A=3A.html> and Elsayed, Sameer <https://research.library.mun.ca/view/creator_az/Elsayed=3ASameer=3A=3A.html> and Conly, John <https://research.library.mun.ca/view/creator_az/Conly=3AJohn=3A=3A.html> (2014) Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador. Canadian Journal of Infectious Diseases and Medical Microbiology, 25 (3). e76-e82. ISSN 1918-1493 cc_by_nc Article PeerReviewed 2014 ftmemorialuniv https://doi.org/10.1155/2014/952603 2023-09-03T06:48:35Z BACKGROUND: USA300 community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI). METHODS: A case series of necrotizing pneumonia presenting as a primary or coprimary infection, secondary to CA-MRSA without evidence of antecedent viral URI, is presented. Cases were identified through the infectious diseases consultation service records. Clinical and radiographic data were collected by chart review and electronic records. MRSA strains were isolated from sputum, bronchoalveolar lavage, pleural fluid or blood cultures and confirmed using standard laboratory procedures. MRSA strains were characterized by susceptibility testing, pulsed-field gel electrophoresis, spa typing, agr typing and multilocus sequence typing. Testing for respiratory viruses was performed by appropriate serological testing of banked sera, or nucleic acid testing of nasopharyngeal or bronchoalveloar lavage specimens. RESULTS: Ten patients who presented or copresented with CA necrotizing pneumonia secondary to CA-MRSA from April 2004 to October 2011 were identified. The median length of stay was 22.5 days. Mortality was 20.0%. Classical risk factors for CA-MRSA were identified in seven of 10 (70.0%) cases. Chest tube placement occurred in seven of 10 patients with empyema. None of the patients had historical evidence of antecedent URI. In eight of 10 patients, serological or nucleic acid testing testing revealed no evidence of acute viral coinfection. Eight strains were CMRSA-10 (USA300). The remaining two strains were a USA300 genetically related strain and a USA1100 strain. CONCLUSION: Pneumonia secondary to CA-MRSA can occur in the absence of an antecedent URI. Infections due to CA-MRSA are associated with significant morbidity and mortality. Clinicians need to have an awareness of this clinical entity, particularly in patients who are in risk groups that predispose to exposure to this bacterium. Article in Journal/Newspaper Newfoundland Memorial University of Newfoundland: Research Repository Newfoundland Canadian Journal of Infectious Diseases and Medical Microbiology 25 3 e76 e82 |
institution |
Open Polar |
collection |
Memorial University of Newfoundland: Research Repository |
op_collection_id |
ftmemorialuniv |
language |
English |
description |
BACKGROUND: USA300 community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) strains causing necrotizing pneumonia have been reported in association with antecedent viral upper respiratory tract infections (URI). METHODS: A case series of necrotizing pneumonia presenting as a primary or coprimary infection, secondary to CA-MRSA without evidence of antecedent viral URI, is presented. Cases were identified through the infectious diseases consultation service records. Clinical and radiographic data were collected by chart review and electronic records. MRSA strains were isolated from sputum, bronchoalveolar lavage, pleural fluid or blood cultures and confirmed using standard laboratory procedures. MRSA strains were characterized by susceptibility testing, pulsed-field gel electrophoresis, spa typing, agr typing and multilocus sequence typing. Testing for respiratory viruses was performed by appropriate serological testing of banked sera, or nucleic acid testing of nasopharyngeal or bronchoalveloar lavage specimens. RESULTS: Ten patients who presented or copresented with CA necrotizing pneumonia secondary to CA-MRSA from April 2004 to October 2011 were identified. The median length of stay was 22.5 days. Mortality was 20.0%. Classical risk factors for CA-MRSA were identified in seven of 10 (70.0%) cases. Chest tube placement occurred in seven of 10 patients with empyema. None of the patients had historical evidence of antecedent URI. In eight of 10 patients, serological or nucleic acid testing testing revealed no evidence of acute viral coinfection. Eight strains were CMRSA-10 (USA300). The remaining two strains were a USA300 genetically related strain and a USA1100 strain. CONCLUSION: Pneumonia secondary to CA-MRSA can occur in the absence of an antecedent URI. Infections due to CA-MRSA are associated with significant morbidity and mortality. Clinicians need to have an awareness of this clinical entity, particularly in patients who are in risk groups that predispose to exposure to this bacterium. |
format |
Article in Journal/Newspaper |
author |
Toro, Christina Moran Janvier, Jack Zhang, Kunyan Fonseca, Kevin Gregson, Dan Laupland, Kevin Rabin, Harvey Elsayed, Sameer Conly, John |
spellingShingle |
Toro, Christina Moran Janvier, Jack Zhang, Kunyan Fonseca, Kevin Gregson, Dan Laupland, Kevin Rabin, Harvey Elsayed, Sameer Conly, John Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
author_facet |
Toro, Christina Moran Janvier, Jack Zhang, Kunyan Fonseca, Kevin Gregson, Dan Laupland, Kevin Rabin, Harvey Elsayed, Sameer Conly, John |
author_sort |
Toro, Christina Moran |
title |
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
title_short |
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
title_full |
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
title_fullStr |
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
title_full_unstemmed |
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador |
title_sort |
community-associated methicillin-resistant staphylococcus aureus in a pediatric emergency department in newfoundland and labrador |
publisher |
Hindawi Publishing Corporation |
publishDate |
2014 |
url |
https://research.library.mun.ca/11991/ https://research.library.mun.ca/11991/1/Hindawi27.pdf https://doi.org/10.1155/2014/952603 |
geographic |
Newfoundland |
geographic_facet |
Newfoundland |
genre |
Newfoundland |
genre_facet |
Newfoundland |
op_relation |
https://research.library.mun.ca/11991/1/Hindawi27.pdf Toro, Christina Moran <https://research.library.mun.ca/view/creator_az/Toro=3AChristina_Moran=3A=3A.html> and Janvier, Jack <https://research.library.mun.ca/view/creator_az/Janvier=3AJack=3A=3A.html> and Zhang, Kunyan <https://research.library.mun.ca/view/creator_az/Zhang=3AKunyan=3A=3A.html> and Fonseca, Kevin <https://research.library.mun.ca/view/creator_az/Fonseca=3AKevin=3A=3A.html> and Gregson, Dan <https://research.library.mun.ca/view/creator_az/Gregson=3ADan=3A=3A.html> and Laupland, Kevin <https://research.library.mun.ca/view/creator_az/Laupland=3AKevin=3A=3A.html> and Rabin, Harvey <https://research.library.mun.ca/view/creator_az/Rabin=3AHarvey=3A=3A.html> and Elsayed, Sameer <https://research.library.mun.ca/view/creator_az/Elsayed=3ASameer=3A=3A.html> and Conly, John <https://research.library.mun.ca/view/creator_az/Conly=3AJohn=3A=3A.html> (2014) Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland and Labrador. Canadian Journal of Infectious Diseases and Medical Microbiology, 25 (3). e76-e82. ISSN 1918-1493 |
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cc_by_nc |
op_doi |
https://doi.org/10.1155/2014/952603 |
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Canadian Journal of Infectious Diseases and Medical Microbiology |
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25 |
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3 |
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e76 |
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e82 |
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