A Life-saving Case of Lung Abscess Caused by Panton-Valentine Leukocidin (PVL)-positive Methicillin-susceptible Staphylococcus aureus (MSSA) at the Sixth Day of Life

Katsuaki Honda, Michishi Kashiwabara, Kakeru Nagaoka, Katsushige Tsutsumi, S. Kikuchi, Hiroshi Sugiura, Shigeru Oki, Hiroshi Kaneko, H. Nakaminami, Katsushige Yabe
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Abstract

We reported a case of Panton-Valentine leukocidin (PVL)-positive methicillin-susceptible Staphylococcus aureus (MSSA) lung abscess at the sixth day of life. The patient was a newborn with 36 weeks of gestation and a birth weight of 2,724 grams. There were no signs of maternal infection, and no easily infected patients with asplenia or hypogammaglobulinemia were observed. At the sixth day of life, he developed rapid respiratory and general deterioration. He was diagnosed with lung abscess and treated with Meropenem and Vancomycin for severe necrotizing pneumonia. Pleural uid culture revealed MSSA, and toxin-producing strains such as PVL were suspected from the response to treatment. Detailed analysis revealed PVL-positive MSSA of sequence type (ST) 30, which is a common community genotype isolated in Japan. Antimicrobial therapy was completed on day 34, and the patient was discharged. Since MSSA is often found in the nasal cavity and skin of healthy individuals, there is concern about the transmission of PVL-positive MSSA within families and in the community. Therefore, when treating neonatal lung abscess caused by Staphylococci, it is necessary to prevent the spread of the disease by checking the infection status of the patient and family members, and by ensuring the proper use of antibiotics and contact precautions.
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潘通-瓦伦丁嗜白细胞素(PVL)阳性的甲氧西林敏感金黄色葡萄球菌(MSSA)在生命第6天引起肺脓肿1例
我们报告了一例潘顿-瓦伦丁白细胞素(PVL)阳性的甲氧西林敏感金黄色葡萄球菌(MSSA)肺脓肿在生命的第6天。患者是一名妊娠36周的新生儿,出生体重为2724克。无母体感染征象,无容易感染的脾功能减退或低丙种球蛋白血症患者。在出生的第六天,他出现了呼吸急促和全身恶化。他被诊断为肺脓肿,并以美罗培南和万古霉素治疗严重坏死性肺炎。胸膜液培养显示MSSA,从对治疗的反应中怀疑有PVL等产毒菌株。分析结果显示,该菌株pvl阳性的MSSA序列型(ST) 30是日本常见的群落基因型。抗菌药物治疗于第34天完成,出院。由于MSSA经常在健康个体的鼻腔和皮肤中发现,因此人们担心pvl阳性MSSA在家庭和社区中的传播。因此,在治疗葡萄球菌引起的新生儿肺脓肿时,有必要通过检查患者和家属的感染状况,并确保正确使用抗生素和接触预防措施,防止疾病的传播。
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