Community-acquired necrotizing pneumonia due to methicillin-sensitive Staphylococcus aureus secreting Panton-Valentine leukocidin: a review of case reports

Annals of Intensive Care

Table 1 Univariate analysis of risk factors associated with mortality in patients with PVL-secreting MSSA-necrotizing CAP

	Died (N = 13)	Survived (N = 19)	Univariate analysis OR (95% CI)	P value
Demographics
Age (yr), mean ± SD	25.6 ± 15.5	23.7 ± 17.2		0.752
Male gender	6/13 (46%)	14/19 (74%)	0.31 (0.07-1.36)	0.15
Clinical characteristics
Influenza-like prodrome^a	9/12 (75%)	4/16 (25%)	9.00 (1.60-50.7)	0.02
Confirmed influenza coinfection	0/3	3/4 (75%)	0.06 (0.002-2.08)	0.143
SSTI on admission	1/13 (8%)	9/19 (47%)	0.09 (0.01-0.86)	0.024
T° < 36° or > 38° on admission	7/11 (63%)	9/11 (82%)	0.39 (0.05-2.77)	0.635
Multilobar involvement	12/12	14/16 (87%)	4.31 (0.19-98.6)	0.492
Lower airway hemorrhage^b	11/12 (92%)	9/16 (56%)	8.56 (0.88-83.1)	0.088
Septic shock	11/11	7/15 (47%)	26.0 (1.30-522)	0.007
Laboratory findings
Leukocytopenia	9/11 (82%)	8/17 (47%)	5.06 (0.83-30.8)	0.115
Thrombocytopenia	2/8 (25%)	6/6	0.03 (0.001-0.75)	0.01
Coagulopathy	9/9	6/8 (75%)	7.31 (0.30-178.7)	0.206
Positive blood cultures	5/13 (38%)	8/17 (47%)	0.56 (0.13-2.41)	0.484
Treatment
Mechanical ventilation	11/12 (92%)	10/14 (71%)	10.7 (0.52-223)	0.33
First-line antibiotics targeting toxin production^c	0/12	0/18	--	1
Intravenous IgG	1/13 (8%)	5/19 (26%)	0.26 (0.03-2.51)	0.361

^aInfluenza-like syndrome > 48 h before admission. Symptoms include fever, shivering, chills, malaise, dry cough, loss of appetite, body aches, and nausea.
^bHemoptysis and/or macroscopic blood on bronchoscopy/BAL.
^cClindamycin, linezolid, or rifampicin,
PVL, Panton-Valentine leukocidin; MSSA, methicillin-sensitive Staphylococcus aureus; CAP, community-acquired pneumonia; SSTI, skin and soft-tissue infection.