Paediatric and adult patients from New Caledonia Island admitted to the ICU for community-acquired Panton-Valentine leucocidin-producing Staphylococcus aureus infections

• Published in: Scientific reports Vol. 12; no. 1; p. 11024
• Main Authors: Imauven, O., Colot, J., Couadau, E., Moury, P.-H., Preault, A., Vincent, F., Montravers, Philippe
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 30.06.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/326; 692/1807; 692/499; 692/699; Adults; Bacteremia; Children; Drug resistance; Human health and pathology; Humanities and Social Sciences; Infections; Infectious diseases; Leukocidin; Life Sciences; Mechanical ventilation; Methicillin; multidisciplinary; Patients; Pediatrics; Respiratory failure; Science; Science (multidisciplinary); Sepsis; Septic shock; Staphylococcus aureus; Vasoactive agents; New Caledonia
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-15337-w

Severe infections involving Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL + Sa) are increasing. This monocentre, retrospective descriptive cohort assessed clinical characteristics and outcome of paediatric and adult patients admitted for community-acquired PVL + Sa infections to the unique intensive care unit (ICU) on New Caledonia Island. Overall, 72 patients (including 23 children) admitted for acute respiratory failure (42%), sepsis/septic shock (21%), and/or postoperative care (32%) were analysed. Most patients had pulmonary (64%), skin/soft tissue (SSTI) (54%) and/or osteoarticular (38%) infections. Multifocal infections (≥ 2 sites) and bacteraemia were reported in 65% and 76% of the patients, respectively. Methicillin-resistant S. aureus isolates were reported in 61% of adult cases versus 30% in children (p < 0.05). Mechanical ventilation, vasoactive support and source control were administered in 53%, 43% and 58% of the patients, respectively. All paediatric patients received adequate empirical antibiotic therapy versus 30/49 adults (p < 0.001). Adequate documented therapy was obtained ≤ 72 h in 70/72 (97%) patients. Death was only reported in adults (n = 10 (14%)), mainly during pulmonary infection (22%), SSTIs (21%) and bacteraemia (24%)). In summary, in ICU patients from New Caledonia Island the clinical presentation of severe community-acquired PVL + Sa infections seems different from Western European observations with high rates of multifocal infections and methicillin-resistant strains.