Gert van der Hoek
In Memoriam - Editor, Senior Moderator
EID Journal Home > Volume 17, Number 1–January 2011
Letter
Empyema caused by MRSA ST398 with Atypical Resistance Profile, Spain
To the Editor: We report a case of empyema caused by methicillin-resistant Staphylococcus aureus (MRSA) sequence type ST398 in a 79-year-old man in Spain who had severe chronic obstructive pulmonary disease.
In 2009, the patient was hospitalized in the intensive care unit because of decompensation of his chronic obstructive pulmonary disease, profound iliofemoral venous thrombosis, right pneumothorax, and lung carcinoma. Thoracic drainage, support measures, and intravenous levofloxacin were initiated, but no clinical improvement was seen.
Purulent exudates from the thoracic drainage tube and of a tracheal aspirate were cultured. MRSA was isolated from both samples and from a nasal swab.
Antimicrobial drug therapy was changed from levofloxacin to intravenous linezolid, but the patient's clinical situation rapidly worsened, and he died of multiorgan failure.
- snip -
In conclusion, we report potential pig-to-human transmission of MRSA ST398. MRSA ST398 can be associated with severe respiratory pathology in immunocompromised patients, and these microorganisms could also be resistant to other first-line antimicrobial agents, such as fluoroquinolones, used to treat these infections.
Moreover, the unusual clindamycin-resistance/erythromycin-susceptibility phenotype might be a key marker (in addition to tetracycline resistance) for the possible presence of livestock-associated MRSA.
http://www.cdc.gov/eid/content/17/1/138.htm
thanks to gpgardiner
Letter
Empyema caused by MRSA ST398 with Atypical Resistance Profile, Spain
To the Editor: We report a case of empyema caused by methicillin-resistant Staphylococcus aureus (MRSA) sequence type ST398 in a 79-year-old man in Spain who had severe chronic obstructive pulmonary disease.
In 2009, the patient was hospitalized in the intensive care unit because of decompensation of his chronic obstructive pulmonary disease, profound iliofemoral venous thrombosis, right pneumothorax, and lung carcinoma. Thoracic drainage, support measures, and intravenous levofloxacin were initiated, but no clinical improvement was seen.
Purulent exudates from the thoracic drainage tube and of a tracheal aspirate were cultured. MRSA was isolated from both samples and from a nasal swab.
Antimicrobial drug therapy was changed from levofloxacin to intravenous linezolid, but the patient's clinical situation rapidly worsened, and he died of multiorgan failure.
- snip -
In conclusion, we report potential pig-to-human transmission of MRSA ST398. MRSA ST398 can be associated with severe respiratory pathology in immunocompromised patients, and these microorganisms could also be resistant to other first-line antimicrobial agents, such as fluoroquinolones, used to treat these infections.
Moreover, the unusual clindamycin-resistance/erythromycin-susceptibility phenotype might be a key marker (in addition to tetracycline resistance) for the possible presence of livestock-associated MRSA.
http://www.cdc.gov/eid/content/17/1/138.htm
thanks to gpgardiner