Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia managed with extracorporeal membrane oxygenation: Experience and outcome

Moronke A. Noah, Michael Dawrant, Gail M. Faulkner, Anne Marie Hill, Chris Harvey, Abid Hussain, David R. Jenkins, Sanjiv Nichani, Giles J. Peek, Andrew W. Sosnowski, Richard K. Firmin

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia, an infection that affects predominantly young people, has a mortality rate of >70% despite aggressive conventional management. Little information is available on the management of patients with Panton-Valentine leukocidin expressing S. aureus pneumonia with extracorporeal membrane oxygenation support. As a large extracorporeal membrane oxygenation center, we reviewed our experience and outcomes with Panton-Valentine Leukocidin expressing S. aureus pneumonia. DATA SOURCES: Locally held register of all extracorporeal membrane oxygenation patients at Glenfield Hospital. STUDY SELECTION: Retrospective study including all patients with sputum-positive Panton-Valentine leukocidin expressing S. aureus pneumonia managed with extracorporeal membrane oxygenation support at a single extracorporeal membrane oxygenation center. DATA SYNTHESIS: On review of our database held from September 1989 until date, there were four patients with sputum-confirmed Panton-Valentine leukocidin expressing S. aureus pneumonia managed with extracorporeal membrane oxygenation. Refractory hypoxemia and/or uncompensated hypercapnia despite optimal conventional management were the indications for extracorporeal membrane oxygenation. After varying periods on extracorporeal membrane oxygenation with appropriate antibiotic and ancillary care, all four patients were discharged home. Conclusions: Panton-Valentine leukocidin expressing S. aureus pneumonia can cause severe, necrotizing pneumonia associated with acute respiratory distress syndrome, which can be particularly challenging to manage. Extracorporeal membrane oxygenation support permits low pressure lung ventilation, avoiding barotrauma to lungs made friable by Panton-Valentine leukocidin expressing S. aureus infection. Although this is a small number of patients, the results are encouraging.

Original languageEnglish (US)
Pages (from-to)2250-2253
Number of pages4
JournalCritical Care Medicine
Volume38
Issue number11
DOIs
StatePublished - Nov 2010
Externally publishedYes

Fingerprint

Staphylococcal Pneumonia
Extracorporeal Membrane Oxygenation
Sputum
Barotrauma
Panton-Valentine leukocidin
Lung
Hypercapnia
Adult Respiratory Distress Syndrome
Infection
Ventilation
Staphylococcus aureus
Retrospective Studies
Databases
Anti-Bacterial Agents
Pressure

Keywords

  • Adult respiratory distress syndrome
  • extracorporeal membrane oxygenation
  • methicillin-resistant Staphylococcus aureus
  • staphylococcal pneumonia
  • Staphylococcus aureus
  • ventilator-induced lung injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia managed with extracorporeal membrane oxygenation : Experience and outcome. / Noah, Moronke A.; Dawrant, Michael; Faulkner, Gail M.; Hill, Anne Marie; Harvey, Chris; Hussain, Abid; Jenkins, David R.; Nichani, Sanjiv; Peek, Giles J.; Sosnowski, Andrew W.; Firmin, Richard K.

In: Critical Care Medicine, Vol. 38, No. 11, 11.2010, p. 2250-2253.

Research output: Contribution to journalArticle

Noah, MA, Dawrant, M, Faulkner, GM, Hill, AM, Harvey, C, Hussain, A, Jenkins, DR, Nichani, S, Peek, GJ, Sosnowski, AW & Firmin, RK 2010, 'Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia managed with extracorporeal membrane oxygenation: Experience and outcome', Critical Care Medicine, vol. 38, no. 11, pp. 2250-2253. https://doi.org/10.1097/CCM.0b013e3181f26490
Noah, Moronke A. ; Dawrant, Michael ; Faulkner, Gail M. ; Hill, Anne Marie ; Harvey, Chris ; Hussain, Abid ; Jenkins, David R. ; Nichani, Sanjiv ; Peek, Giles J. ; Sosnowski, Andrew W. ; Firmin, Richard K. / Panton-Valentine leukocidin expressing Staphylococcus aureus pneumonia managed with extracorporeal membrane oxygenation : Experience and outcome. In: Critical Care Medicine. 2010 ; Vol. 38, No. 11. pp. 2250-2253.
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AU - Hill, Anne Marie

AU - Harvey, Chris

AU - Hussain, Abid

AU - Jenkins, David R.

AU - Nichani, Sanjiv

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KW - Adult respiratory distress syndrome

KW - extracorporeal membrane oxygenation

KW - methicillin-resistant Staphylococcus aureus

KW - staphylococcal pneumonia

KW - Staphylococcus aureus

KW - ventilator-induced lung injury

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