Pneumonija izazvana koagulaza-pozitivnim meticilin rezistentnim Staphylococcus aureus-om

  • Biljana Lazović Clinical Hospital Center Zemun, Department of Pulmonology, Belgrade, Serbia
  • Radmila Dmitrović Clinical Hospital Center Zemun, Department of Pulmonology, Belgrade, Serbia
  • Isidora Simonović Clinical Hospital Center Zemun, Department of Pulmonology, Belgrade, Serbia
  • Nevena Jovičić University Children’s Hospital, Belgrade, Serbia
  • Sanja Šarac Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
  • Rade Milić Military Medical Academy, Pulmonology Clinic, Belgrade, Serbia
  • Vuk Aleksić Clinical Hospital Center Zemun, Department of Pulmonology, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP200808009L
Ključne reči: antibiotici, bronhoskopija, koagulaza, meticilin, rezistencija, pneumonija, staphylococcus aureus

Sažetak


Uvod. Staphylococcus (S.) aureus je jedan od najprisutnijih i najopasnijih humanih patogena čija je glavna karakteristika stvaranje enzima koagulaze. Ova karakteristika omogućava identifikaciju i procenu patogenosti bakterije. Pored kožnih infekcija, endokarditisa, osteomijelitisa i infektivnog artritisa, čest je uzročnik pneumonije kako kod dece tako i kod odraslih. Prikaz bolesnika. Prikazana je žena starosti 65 godina, sa tegobama u vidu suvog kašlja i malaksalosti, sa rentgenskim nalazom mrljastih polja konsolidacije i promenama tipa „mlečnog stakla“ sa zadebljanjem bronhijalnog zida i jednostranom medijastinalnom limfadenopatijom na snimku grudnog koša dobijenom kompjuterizovanom tomografijom. Meticilin rezistentni S. aureus izolovan je iz bronhoalveolarnog aspirata uzorkovanog tokom bronhoskopije. Bolesnica je empirijski lečena azitromicinom, a kasnije, na osnovu rezultata antibiograma, isključen je azitromicin i uveden meropenem posle čega je usledilo poboljšanje zdravstvenog stanja bolesnice. Zaključak. Prikazan je redak slučaj pneumonije sa neubedljivom simptomatologijom, laboratorijskim i radiološkim nalazima. Neophodno je posvetiti više pažnje ovakvim slučajevima ubuduće, posebno na upotrebu antibiotika na koje stafilokoke sve više razvijaju rezistenciju.

Reference

1. Bush LM, Vasquez- Pertejo MT. Staphylococcal infections. MSD MANUAL Professional version. Available from: https://www.msdmanuals.com/en-jp/professional/infectionu s-diseases/gram-positive-cocci/staphylococcal-infections# [last modified March 2021].

2. Berger-Jekić O, Dinić M, Đukić S, Jelesić Z, Kocić B, Kulauzov M, et al. Medical bacteriology. Belgrade: Savremena administracija; 2008. (Serbian)

3. McEachern R, Campbell GD Jr. Hospital-acquired pneumonia: epidemiology, etiology, and treatment. Infect Dis Clin North Am 1998 Sep; 12(3): 761–79, x.

4. Richards MJ, Edwards JR, Culver DH, Gaynes RP. Nosocomial in-fections in medical intensive care units in the United States. National Nosocomial Infections Surveillance System. Crit Care Med 1999; 27(5): 887‒92.

5. Carleton HA, Diep BA, Charlebois ED, Sensabaugh GF, Perdreau-Remington F. Community-adapted methicillin-resistant Staphy-lococcus aureus (MRSA): population dynamics of an expand-

ing community reservoir of MRSA. J Infect Dis 2004; 190(10): 1730‒8.

6. Center for Disease Control and Prevention. Community asso-ciated MRSA. Information from the US Centers for Disease Control and Prevention. Available from: http://www.cdc gov/ncidod/hip/ARESIST/mrsa_comm_faq.htm [accessed 2005 July 31].

7. Jacobs DM, Shaver A. Prevalence of and outcomes from staphylo-coccus aureus pneumonia among hospitalized patients in the United States, 2009-2012. Am J Infect Control 2017; 45(4): 404‒9.

8. Santos JW, Nascimento DZ, Guerra VA, Rigo Vda S, Michel GT, Dalcin TC. Community-acquired staphylococcal pneumonia. J Bras Pneumol 2008; 34(9): 683‒9. (English, Portuguese)

9. Carrillo-Marquez MA, Hulten KG, Hammerman W, Lamberth L, Mason EO, Kaplan SL. Staphylococcus aureus pneumonia in children in the era of community-acquired methicillin-resistance at Texas Children's Hospital. Pediatr Infect Dis J 2011; 30(7): 54550.

10. Lewis SS, Walker VJ, Lee MS, Chen L, Moehring RW, Cox CE, et al. Epidemiology of methicillin-resistant Staphylococcus aure-us pneumonia in community hospitals. Infect Control Hosp Epidemiol 2014; 35(12): 1452‒7.

11. Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, Albercth V, Limbago B, et al. MERGEncy ID NET Study Group. Preva-lence of Methicillin-resistant Staphylococcus aureus as an eti-ology of community-acquired pneumonia. Clin Infect Dis 2012; 54(8): 1126‒33.

12. Chen J, Luo Y, Zhang S, Liang Z, Wang Y, Zhang Y, et al. Com-munity-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus producing Panton-Valentine leukocidin in a Chinese teenager: case report and literature re-view. Int J Infect Dis 2014; 26: 17‒21.

13. Liu CW, Lin SP, Wang WY, Huang YH. Influenza With Com-munity-Associated Methicillin-Resistant Staphylococcus Aure-us Pneumonia. Am J Med Sci 2019; 358(4): 289‒93.

14. Thomas R, Ferguson J, Coombs G, Gibson PG. Community-acquired methicillin-resistant Staphylococcus aureus pneumo-nia: a clinical audit. Respirology 2011; 16(6): 926‒31.

15. Morikawa K, Okada F, Ando Y, Ishii R, Matsushita S, Ono A, et al. Meticillin-resistant staphylococcus aureus and meticillin-

susceptible S. aureus pneumonia: comparison of clinical and thin-section CT findings. Br J Radiol 2012; 85(1014): e168‒75.

16. González C, Rubio M, Romero-Vivas J, González M, Picazo JJ. Staphylococcus aureus bacteremic pneumonia: differences be-tween community and nosocomial acquisition. Int J Infect Dis 2003; 7(2): 102‒8.

17. File TM Jr. Treatment of community-acquired pneumonia in adults who require hospitalization. Available from: https://www.uptodate.com/contents/treatment-of-communit y-acquired-pneumonia-in-adults-who-require-hospitalization# H4033052510 [updated 2021 September 3].

18. Wunderink RG, Niederman MS, Kollef MH, Shorr AF, Kunkel MJ, Baruch A, et al. Linezolid in methicillin-resistant staphylococ-cus aureus nosocomial pneumonia: a randomized, controlled study. Clin Infect Dis 2012; 54(5): 621‒9.

19. Kaysin A, Viera AJ. Community-acquired pneumonia in adults: diagnosis and management. Am Fam Physician 2016; 94(9): 698‒706.

Objavljeno
2023/04/05
Broj časopisa
Vol. 80 Br. 02 (2023): Vojnosanitetski pregled
Rubrika
Prikaz bolesnika