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

O. Imauven (1, 2) , J. Colot (3, 4) , E. Couadau (3) , P.-H. Moury (3, 4, 5, 6) , A. Preault (3) , F. Vincent (3) , Philippe Montravers (7, 8)

1 GRC 29 - ARPE - Groupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire
2 SU - Sorbonne Université
3 CHT - Centre hospitalier territorial Gaston-Bourret [Dumbea]
4 Institut Pasteur de Nouvelle-Calédonie
5 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
6 HP2 - Hypoxie et PhysioPathologie
7 PHERE (UMR_S_1152 / U1152) - Physiopathologie et Epidémiologie des Maladies Respiratoires
8 AP-HP - Hôpital Bichat - Claude Bernard [Paris]

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.

Domaines: Maladies infectieuses

O. Imauven, J. Colot, E. Couadau, P.-H. Moury, A. Preault, et al.. Paediatric and adult patients from New Caledonia Island admitted to the ICU for community-acquired Panton-Valentine leucocidin-producing Staphylococcus aureus infections. Scientific Reports, 2022, 12 (1), pp.11024. ⟨10.1038/s41598-022-15337-w⟩. ⟨hal-03741176⟩