A 4-month-old boy with fatal pneumonia transmitted Panton-Valentine leukocidin-producing Staphylococcus aureus to a physician who had attempted to resuscitate him.
This case represents the first reported incident of Panton-Valentine leukocidin- producing S. aureus transmission during resuscitation, said Martin Chalumeau, M.D., of the Hôpital Saint-Vincent de Paul, Paris, and his colleagues (Clin. Infect. Dis. 2005;41:e29–30).
The resuscitation occurred in the general pediatric ward, when the child went into cardiac arrest while being examined by a physician. None of the health care personnel involved in the resuscitation efforts was wearing a face mask or gloves.
Necroscopy results revealed right lobar pneumonia, a necrotizing hemorrhage of the right lung and half of the left lung, and a tracheal aspirate culture that yielded methicillin-susceptible S. aureus (MSSA). The child had presented with 3 days of coughing and 1 day of fever, and had a normal chest radiogram. He developed progressive respiratory failure within 12 hours of hospital admission.
Five days after the incident, the physician who performed the oral intubation on the child had developed furuncles on the fingers and face, and MSSA was found in cultures from the skin lesions. In addition, MSSA was found in cultures collected from 5 of the 15 health care workers who were involved in the resuscitation. The presence of Panton-Valentine leukocidin, a cytotoxin associated with tissue necrosis and leukocyte destruction, was confirmed in the child and the infected physician, but not in the other health care workers.
This incident emphasizes the importance of protecting health care workers against infection, even in general care wards.