Table 1.
Characterization of patients with Panton-Valentine leukocidin-producing Staphylococcus aureus (PVL-SA) infection.
| Number of Patients (%) | ||||
|---|---|---|---|---|
| Characteristics | All Patients | Mild Disease: Multiple/Recurrent Furunculosis Or Skin Abscesses | Moderate Disease: Cellulitis or Phlegmon | Severe Disease: Septic Shock + Necrotizing Pneumonia or Osteomyelitis |
| All patients | 21/21 (100) | 14/21 (67) | 3/21 (14) | 4 */21 (19) |
| Male gender | 14/21 (67) | 9/14 (64) | 2/3 (67) | 3/4 (75) |
| Relevant comorbidities | ||||
| Diabetes mellitus | 3/21 (14) | 2/14 (14) | 0 | 1/4 (25) |
| HIV | 2 °/21 (10) | 1/14 (7) | 1/3 (33) | 0 |
| Autoimmune disease | 2 #/21 (10) | 1/14 (7) | 0 | 1/4 (25) |
| Asthma | 1/21 (5) | 0 | 1/3 (33) | 0 |
| Intravenous drug use | 1/21 (5) | 0 | 0 | 1/4 (25) |
| Type of case | ||||
| Primary | 19/21 (90) | 12/14 (86) | 3/3 (100) | 4/4 (100) |
| Secondary | 2/21 (10) | 2/14 (14) | 0 | 0 |
| Recent travel history | ||||
| None | 9/21 (63) | 2/14 (14) | 2/3 (67) | 4/4 (100) |
| European countries, other than Portugal | 1 §/21 (5) | 1/14 (7) | 0 | 0 |
| Africa | 8 ^/21 (38) | 8/14 (57) | 0 | 0 |
| Asia | 2 $/21 (10) | 1/14 (7) | 1/3 (33) | 0 |
| USA | 1/21 (5) | 1/14 (7) | 0 | 0 |
| Purpose of travel, if any | ||||
| Birthplace and country of residence | 4/12 (33) | 4/11 (36) | 0 | 0 |
| Visiting friends and family | 3/12 (25) | 3/11 (27) | 0 | 0 |
| Business | 2/12 (17) | 2/11 (18) | 0 | 0 |
| Leisure | 2/12 (17) | 1/11 (9) | 1/1 (100) | 0 |
| Humanitarian work | 1 (8) | 1/11 (9) | 0 | 0 |
| Length of the disease until microbiological diagnosis | ||||
| Number of episodes | ||||
| 1 | 10/21 (48) | 4/14 (29) | 2/3 (67) | 4/4 (100) |
| 2 to 4 | 7/21 (33) | 7/14 (50) | 0 | 0 |
| 5 or more | 4/21 (19) | 3/14 (21) | 1/3 (33) | 0 |
| Number of systemic antibiotic treatments | ||||
| 1 | 12 (57) | 6/14 (43) | 2/3 (67) | 4/4 (100) |
| 2 to 4 | 5 (24) | 5/14 (36) | 0 | 0 |
| 5 or more | 4/21 (19) | 3/14 (21) | 1/3 (33) | 0 |
| Relative neutropenia ** | 2/21 (9,5) | 2/14 (14) | 0 | 0 |
| Biological sample from which PVL-SA was recovered | ||||
| Pus | 18 °°/21 (86) | 14/14 (100) | 3/3 (100) | 1/4 (25) |
| Respiratory samples | 2/21 (10) | 0 | 0 | 2/4 (50) |
| Pleural fluid | 1/21 (5) | 0 | 0 | 1/4 (25) |
| Need for invasive procedures | 9/21 (43) | 4/14 (29) | 3/3 (100) | 2/4 (50) |
| Need for hospital admission | 7/21 (33) | 1/14 (7) | 2/3 (67) | 4/4 (100) |
| Need for intensive care unit admission | 4/21 (19) | 0 | 0 | 4/4 (100) |
| Decolonization performed | 13/21 (62) | 9/14 (64) | 1/3 (33) | 3/4 (75) |
| Recurrence after decolonization | 2 ## (10) | 2/9 (22) | 0 | 0 |
HIV: human immunodeficiency virus; USA: United States of America; TMP/SMX: trimethoprim/sulfamethoxazole. * One pediatric patient with septic shock due to cellulitis, osteomyelitis and compartment syndrome, and three adult patients with septic shock due to necrotizing pneumonia. ° One patient was on antiretroviral therapy, suppressed and with a TCD4+ cell count >500/mm3; the other patient had no antiretroviral treatment and had a TCD4+ cell count of 154/mm3. # One patient had Hashimoto thyroiditis and the other ulcerative colitis; none of them had systemic immunosuppressive treatment. § An Italian patient, currently in Portugal for vacation. ^ Five patients came from Angola, two from Guinea Bissau and one from Mozambique. $ Two patients, recently returned from vacations, one in Thailand and the other in India. ** Data only available for 11 patients (4 with severe disease, 2 with moderate disease, 5 with mild disease). No patient had absolute neutropenia. °° In the osteomyelitis patient, S. aureus was isolated both from pus and also from bone samples. ## Both patients had probable secondary cases in close relatives who did not comply with decolonization recommendations.