Semin Respir Crit Care Med 2005; 26: 643-649 DOI: 10.1055/s-2005-925528
Published © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Staphylococcus aureus Pneumonia: Emergence of MRSA in the Community
Suzanne F. Bradley1,2
1 Department of Internal Medicine, Divisions of Infectious Diseases and Geriatric Medicine, University of Michigan Medical School, Ann Arbor, Michigan 2 Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan

ABSTRACT

The clinical presentation of staphylococcal pneumonia is changing. Healthy young people without traditional risk factors for Staphylococcus aureus disease are presenting with severe necrotizing infection and high mortality. The clinical picture is reminiscent of outbreaks of postinfluenzal staphylococcal pneumonia seen in the past century. Most of these staphylococcal strains are methicillin-resistant and are not health care associated. Many strains contain toxins that are likely responsible for the severity of illness seen. Panton-Valentine leukocidin has rarely been identified in S. aureus until recently. It appears that the genetic element for methicillin resistance has been introduced into multiple highly virulent methicillin-susceptible strains with great potential for further spread. Early recognition and treatment of possible community-acquired methicillin-resistant S. aureus (CA-MRSA) is essential. It is equally important to attain microbiological confirmation of the diagnosis for optimal treatment and to initiate appropriate infection control procedures.

KEYWORDS

Methicillin resistance - pneumonia - staphylococci