Dataset Information

Two Cases of Influenza B Virus-Related Fatal Fulminant Pneumonia Complicated With Staphylococcus aureus Infection in China Diagnosed Using Next-Generation Sequencing (2018).

ABSTRACT: Two rare cases of Chinese female patients with influenza B virus infection complicated with both fulminant pneumonia and septicemia caused by Panton-Valentine leukocidin(PVL) positive methicillin-sensitive Staphylococcus aureus (MASS) were reported for the first time in China through next-generation sequencing (NGS). An increasing body of evidence indicates that co-infection with influenza B virus and bacterial pneumonia is often fatal. Rapid and precise identification of the co-infection bacteria can guide the selection of treatment for patients with influenza virus infection in the clinical setting. In this study, next-generation sequencing (NGS) was applied for the rapid diagnosis of these two cases. Despite the unfavorable survival outcome of these patients, the application of next-generation sequencing showed promise as a diagnostic tool for the rapid diagnosis of unknown pathogens in patients with bacterial pneumonia and sepsis. This method can guide the administration of medications in such patients.

SUBMITTER: Bai B

PROVIDER: S-EPMC7175880 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Two Cases of Influenza B Virus-Related Fatal Fulminant Pneumonia Complicated With <i>Staphylococcus aureus</i> Infection in China Diagnosed Using Next-Generation Sequencing (2018).

Bai Bing B Wang Hongyan H Li Meng M Ma Xiaoyu X Zheng Jinxin J Deng Qiwen Q Yu Zhijian Z

Frontiers in public health 20200415

Two rare cases of Chinese female patients with influenza B virus infection complicated with both fulminant pneumonia and septicemia caused by Panton-Valentine leukocidin(PVL) positive methicillin-sensitive <i>Staphylococcus aureus</i> (MASS) were reported for the first time in China through next-generation sequencing (NGS). An increasing body of evidence indicates that co-infection with influenza B virus and bacterial pneumonia is often fatal. Rapid and precise identification of the co-infection ...[more]

PMID: 32351925

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Project description:IntroductionStaphylococcus aureus produces numerous toxins, such as toxic shock syndrome toxin 1 (TSST-1) and Panton-Valentine leukocidin (PVL). We isolated community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) strains producing both TSST-1 and PVL isolated from severe necrotizing pneumonia cases in a Nepali family. Detection of these CA-MRSA strains is rare in the world, and infection with these strains can take a rapidly progressive and lethal course. In this study, we traced the clinical course of this case and conducted a genetic analysis of the isolated strains.Case reportWe described 2 familial cases (a 20-year-old male and 61-year-old female) of severe necrotizing pneumonia caused by CA-MRSA with the TSST-1 and PVL genes. A 20-year-old Nepalese male was admitted to our hospital after a 3-day history of high fever and coughing. Despite resuscitation efforts, he died of multiple organ failure. A 61-year-old Nepalese female was admitted to our hospital with a complaint of high fever and dyspnea for 1 day. She was the grandmother of the male subject and mostly stayed at his residence in Japan. We administered intravenous antibiotics, including anti-MRSA antibiotics, and she improved in 2 weeks. The sequence type of the isolates was ST22/SCCmec type IVa, and the spa type was t005. The virulence genes detected were as follows: PVL gene (lukSF-pv), TSST-1 gene (tst-1), sec, seg, sei, sel, sem, sen, seo, and seu. ST22 was not the dominant CA-MRSA clone type in Japan. Some of the reports demonstrated that PVL-/TSST-1-positive ST22-MRSA strains are prevalent in Nepal. Therefore, the MRSA strains were thought to be acquired from Nepal.ConclusionThese cases highlight the emergence of TSST-1- and PVL-positive CA-MRSA infection and its association with life-threatening community-acquired necrotizing pneumonia. Clinicians should note the possibility of introducing MRSA strains from abroad and be aware of this illness to initiate appropriate treatment.

Project description:BackgroundMany studies have shown that Staphylococcus aureus is a leading cause of both community onset and hospital onset bloodstream infections. However, relatively little is known about the occurrence and outcome of S. aureus bacteremia in sub-Saharan Africa. A previous report indicated that S. aureus accounts for 16% of community onset and 6% of hospital onset bloodstream infections at Aga Khan University Hospital Nairobi (AKUHN). Data about the etiology of S. aureus bacteremia in sub-Saharan Africa will help optimize recognition and treatment. This study was performed in order to understand the etiologies and risk factors for S. aureus bacteremia in a sub-Saharan location.Materials and methodsA review of the electronic record of laboratory results from September 2010 through December 2018 identified 201 patients seen at AKUHN with S. aureus bacteremia. The source and/or focus of infection was identified and in-hospital mortality was determined. Cases with bacteremia after three days of hospitalization were considered hospital acquired. Community onset cases were divided into community acquired and health care associated.ResultsMost cases (71%; 143/201) were community onset, but only 41% (83/201) of these cases were community acquired. The most commonly identified foci of infection for community acquired bacteremia were musculoskeletal (25%; 21/83) and skin and soft tissue (24%; 20/83). The majority of health care associated (70%; 40/57) and hospital acquired cases (74%; 43/58) were associated with invasive vascular devices, with peripheral IVs being the most common for hospital acquired and dialysis catheters being the most common for health care associated infections. In-hospital mortality rates were 23% (19/83) for community acquired, 19% (11/57) for health care associated and 33% (19/58) for hospital acquired infections.ConclusionInvasive vascular devices were associated with a substantial portion of cases of S. aureus bacteremia and provide an important target for infection control efforts.

Dataset Information

Two Cases of Influenza B Virus-Related Fatal Fulminant Pneumonia Complicated With Staphylococcus aureus Infection in China Diagnosed Using Next-Generation Sequencing (2018).

Publications

Two Cases of Influenza B Virus-Related Fatal Fulminant Pneumonia Complicated With <i>Staphylococcus aureus</i> Infection in China Diagnosed Using Next-Generation Sequencing (2018).

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