Staphylococcus Aureus Pneumonias Clinical Trial
Official title:
Panton Valentine Leucocidin : Independent Severity Factor of Staphylococcus Aureus Pneumonias
Staphylococcus aureus expresses a variety of virulence factors, including Panton Valentine
leukocidin (PVL), a cytotoxin. PVL is specifically associated with primary skin and
soft-tissue infections and severe necrotizing pneumonia (Gillet et al. Lancet,
2002;359:753-9). PVL-positive S. aureus pneumonia is often preceded by influenza-like
symptoms, and is mainly characterized by hemoptysis, pleural effusion, rapid onset of acute
respiratory distress, leukopenia and a high fatality rate (65%) (Gillet et al. Lancet,
2002;359:753-9). Ten year after the first description of this disease and a number of
controversies in the scientific literature, the question arise as to whether PVL remains an
independent factor of severity in S.aureus pneumonia. In addition, numerous questions remain
unanswered yet; these are:
- (i) which factors, including treatment regimen, are associated with favourable outcome?,
- (ii) what is the susceptibility toward antibiotics of strains associated with this
disease ?
- (iii) is there any genetic susceptibility of the host to explain both the rarity, and
the explosive presentation of the disease ? To address the above questions a prospective
observational study at the nationwide level will be set up. All French hospitals will be
invited to describe the clinical features of all new cases of S. aureus
community-acquired pneumonia with severity criteria, regardless PVL production. The
study will include an investigation of a possible innate immune dysfunction in
collaboration with the INSERM-U550 (Génétique Humaine des Maladies Infectieuses, Faculté
Necker, Paris). Hence, in addition to collecting clinical and biological data from all
pneumonia cases as well as all strains of S. aureus isolated, the patients with
PVL-positive pneumonia will be sampled for immune genetic studies (ORFeome sequencing
and functional studied)
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