Neumonía necrosante por Staphylococcus aureus extrahospitalario resistente a la meticilina:reporte de dos casos en Colombia
Palabras clave:
Staphylococcus aureus, resistencia a la meticilina, infecciones comunitarias adquiridas, neumonía estafilocócica, leucocidinas, farmacorresistencia bacteriana, insuficiencia renal aguda, Colombia
Resumen
En los últimos años se ha informado la aparición de Staphylococcus aureus resistente a la meticilina como causa de infecciones extrahospitalarias graves. En Colombia, en el 2006, se publicó el primer reporte de S. aureus como causa de infección de piel y tejidos blandos; en esta ocasión, presentamos el primer reporte de neumonía necrosante con etiología por S. aureus, en dos pacientes adultos que se caracterizaron por presentar progresión clínica rápida, estancia prolongada en cuidados intensivos y complicación de la neumonía con aparición de empiema.Ambos desarrollaron falla renal aguda, por lo que fueron manejados con linezolide, con adecuada respuesta clínica. Con la caracterización molecular de los aislamientos se confirmó la presencia del gen mecA que porta el casete SCCmec tipo IV y la producción de la toxina leucocidina Panton-Valentine.
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Referencias bibliográficas
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14. Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1.
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19. Bubeck-Wardenburg J, Palazzolo-Ballance AM, Otto M, Schneewind O, DeLeo FR. Panton-Valentine leukocidin is not a virulence determinant in murine models of community-associated methicillin-resistant Staphylococcus aureus disease. J Infect Dis. 2008;198:1166-70.
20. de Miranda OP, Silva-Carvalho MC, Ribeiro A, Portela F, Cordeiro RP, Caetano N, et al. Emergence in Brazil of methycillin-resistant Staphylococcus aureus isolates carrying SCCmecIV that are related genetically to the USA800 clone. Clin Microbiol Infect. 2007;13:1165-72.
21. Sola C, Saka HA, Vindel A, Bocco JL, Córdoba S. aureus Collaborative Study Group. High frequency of Panton-Valentine leukocidin genes in invasive methycillin-susceptible Staphylococcus aureus strains and the relationship with methicyllin-resistant Staphylococcus aureus in Cordoba, Argentina. Eur J Clin Microbiol Infect Dis. 2007;26:281-6.
22. Gardella N, von Specht M, Cuirolo A, Rosato A, Gutkind G, Mollerach M. Community-associated methycillin-resistant Staphylococcus aureus, eastern Argentina. Diagn Microbiol Infect Dis. 2008;62:343-7.
23. Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, et al. Severe community acquired pneumonia due to Staphylococcus aureus, 2003-2004, influenza season. Emerg Infect Dis. 2006;12:894-9.
24. Diep BA, Otto M. The role of virulence determinants in community-associated MRSA pathogenesis. Trends Microbiol. 2008;16:361-9.
25. Nguyen ET, Kanne JP, Hoang LM, Reynolds S, Dhingra V, Bryce E, et al. Community acquired methycillin resistant Staphylococcus aureus pneumonia: radiographic and computed tomography findings. J Thorac Imaging. 2008;23:13-9.
26. Stevens DL, Ma Y, Salmi DB, McIndoo E, Wallace RJ, Bryant AE. Impact of antibiotics on expression of virulence-associated exotoxin genes in methicillin-sensitive and methycillin-resistant Staphylococcus aureus. J Infect Dis. 2007;195:202-11.
2. Labandiera-Rey M, Couzon F, Boisset S, Brown EL, Bes M, Benito Y, et al. Staphylococcus aureus Panton-Valentine leukocidin causes necrotizing pneumonia. Science. 2007;315:1130-3.
3. Wang R, Braughton KR, Kretschmer D, Bach TH, Queck SY, Li M, et al. Identification of novel cytolytic peptides as key virulence determinants for community-associated MRSA. Nat Med. 2007;13:1510-4.
4. Diep BA, Stone GG, Basuino L, Graber CJ, Miller A, des Etages SA, et al. The arginine catabolic mobile element and staphylococcal chromosomal cassette mec linkage: convergence of virulence and resistance in the USA300 clone of methicillin-resistant Staphylococcus aureus. J Infec Dis. 2008;197:1523-30.
5. Gillet Y, Vanhems P, Lina G, Bes M, Vandenesch F, Floret D, et al. Factors predicting mortality in necrotizing community acquired pneumonia caused by Staphylococcus aureus containing Panton-Valentine leukocidin. Clin Infect Dis. 2007;45:315-21.
6. Caballero AS, Martínez E, Giraldo H, Álvarez CA, Torres CA, Saavedra C, et al. Recomendaciones para el diagnóstico, tratamiento y prevención de la neumonía adquirida en la comunidad en adultos. Infectio. 2004;8:8-44.
7. Martineau F, Picard FJ, Lansac N, Mènard C, Roy PH, Ouellete M, et al. Correlation between the resistance genotype determined by multiplex PCR assays and the antibiotic susceptibility patterns of Staphylococcus aureus and Staphylococcus epidermidis. Antimicrob Agents Chemother. 2000;44:231-8.
8. Clinical and Laboratory Standards Institute (CLSI). Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard. Seventh Edition and Performance Standards for Antimicrobial Susceptibility Testing; Eighteenth Informational Supplement M7-A7 25. Philadelphia: CLSI; 2008.
9. Milheiriço C, Oliveira DC, de Lencastre H. Multiplex PCR strategy for subtyping the staphylococcal cassette chromosome mec type IV in methicillin-resistant Staphylococcus aureus: ‘SCCmec IV multiplex’. J Antimicrob Chemother. 2007;60:42-8.
10. Jarraud S, Mougel C, Thioulouse J, Lina G, Meugnier H, Forey F, et al. Relationships between Staphylococcus aureus genetic background, virulence factors, agr groups (alleles), and human disease. Infect Immun. 2002;70:631-41.
11. Tristan A, Ying L, Bes M, Etienne J, Vandenesch F, Lina G. Use of multiplex PCR to identify Staphylococcus aureus adhesins involved in human hematogenous infections. J Clin Microbiol. 2003;41:4465-7.
12. Diep BA, Gill SR, Chang RF, Phan TH, Chen JH, Davidson MG, et al. Complete genome sequence of USA300, an epidemic clone of community-acquired methycillin-resistant Staphylococcus aureus. Lancet. 2006;4;367:731-9.
13. Tenover FC, Abeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, et al. Interpreting chromosomal DNA restriction patterns produced by pulsed-field electrophoresis: criteria for bacterial strain typing. J Clin Microbiol. 1995;33:2233-9.
14. Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community associated methicillin resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1.
15. Ribeiro A, Dias C, Silva-Carvalho M, Berquo L, Ferreira F, Santos RN, et al. First report of infection with community acquired methycillin resistant Staphylococcus aureus in South America. J Clin Microbiol. 2005;43:1985-8.
16. Arias C, Rincón S, Chowdhury S, Martínez E, Coronell W, Reyes J, et al. MRSA USA 300 clone and VREF -a U.S.- Colombian connection? N Engl J Med. 2008;359:2177-9.
17. Yomayusa N, Leal L, Álvarez C, Escobar J, Suárez IC, Ibáñez M, et al. Caracterización epidemiológica y molecular de infecciones causadas por Staphylococcus aureus resistente a meticilina adquirido en comunidad (SARM–AC) en 7 hospitales de Colombia. Infectio. 2008;12:73.
18. Cortés JA, Gómez CA, Cuervo SI, Leal AL. Community-acquired methycillin-resistant Staphylococcus aureus in Bogotá, Colombia: public health implications. Rev Salud Pública. 2007;9:448-54.
19. Bubeck-Wardenburg J, Palazzolo-Ballance AM, Otto M, Schneewind O, DeLeo FR. Panton-Valentine leukocidin is not a virulence determinant in murine models of community-associated methicillin-resistant Staphylococcus aureus disease. J Infect Dis. 2008;198:1166-70.
20. de Miranda OP, Silva-Carvalho MC, Ribeiro A, Portela F, Cordeiro RP, Caetano N, et al. Emergence in Brazil of methycillin-resistant Staphylococcus aureus isolates carrying SCCmecIV that are related genetically to the USA800 clone. Clin Microbiol Infect. 2007;13:1165-72.
21. Sola C, Saka HA, Vindel A, Bocco JL, Córdoba S. aureus Collaborative Study Group. High frequency of Panton-Valentine leukocidin genes in invasive methycillin-susceptible Staphylococcus aureus strains and the relationship with methicyllin-resistant Staphylococcus aureus in Cordoba, Argentina. Eur J Clin Microbiol Infect Dis. 2007;26:281-6.
22. Gardella N, von Specht M, Cuirolo A, Rosato A, Gutkind G, Mollerach M. Community-associated methycillin-resistant Staphylococcus aureus, eastern Argentina. Diagn Microbiol Infect Dis. 2008;62:343-7.
23. Hageman JC, Uyeki TM, Francis JS, Jernigan DB, Wheeler JG, Bridges CB, et al. Severe community acquired pneumonia due to Staphylococcus aureus, 2003-2004, influenza season. Emerg Infect Dis. 2006;12:894-9.
24. Diep BA, Otto M. The role of virulence determinants in community-associated MRSA pathogenesis. Trends Microbiol. 2008;16:361-9.
25. Nguyen ET, Kanne JP, Hoang LM, Reynolds S, Dhingra V, Bryce E, et al. Community acquired methycillin resistant Staphylococcus aureus pneumonia: radiographic and computed tomography findings. J Thorac Imaging. 2008;23:13-9.
26. Stevens DL, Ma Y, Salmi DB, McIndoo E, Wallace RJ, Bryant AE. Impact of antibiotics on expression of virulence-associated exotoxin genes in methicillin-sensitive and methycillin-resistant Staphylococcus aureus. J Infect Dis. 2007;195:202-11.
Cómo citar
Perilla, A. M., González, C., Valderrama, S. L., Vanegas, N., Chavarro, B., Triana, L. C., Támara, J. R., & Álvarez, C. A. (2009). Neumonía necrosante por Staphylococcus aureus extrahospitalario resistente a la meticilina:reporte de dos casos en Colombia. Biomédica, 29(4), 523-30. https://doi.org/10.7705/biomedica.v29i4.126
Publicado
2009-12-01
Número
Sección
Presentación de caso
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