Two Cases of Intrafamilial Transmission of Community-Acquired Methicillin-Resistant Staphylococcus aureus Producing Both PVL and TSST-1 Causing Fatal Necrotizing Pneumonia and Sepsis

Figures & data

Figure 1 A chest computed tomography (CT) scan in Case 1 shows infiltrative and nodular shadows with pneumatocele formation in the right upper lobe.

Figure 2 Bronchoscopy in Case 1 shows diffuse inflammatory changes and easy bleeding.

Figure 3 A chest CT scan in Case 2 shows irregular consolidations, ground glass opacity and bilateral pleural effusion.

Table 1 Genetic Characteristics and Virulence Factors in Two Isolates in This Study

Isolates	Genotype						Resistant Gene		Antimicrobial Susceptibility (μg/mL)
	SCCmec	MLST	spa	coa	agr	Virulent Gene	Acquired	Mutations	EM	CLDM	LVFX	MINO	ST	ABK	VCM	LZD
TUM18988 and TUM18990	IVa	ST22	t005	XIa	I	lukSF-pv, tst-1, sec, seg, sei, sel, sem, sen, seo, seu	blaZ, mecA, aadD, aac(6ʹ)-aph(2”), erm(C), tem(M)	grlA (S80F), gyrA (S84L)	>4	≤0.5	>4	≤1	≤0.5	≤1	1	1