Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Do MRSA Strains Producing PSM Toxin Cause Septic Shock In People With Weak Immune System?
Question:
Hello !!
I have question about CA MRSA that can develop very fast – and cause severe invasive blood stream infections like septic shock.
Some CA-MRSA strains display enhanced virulence, spreading more rapidly and causing illness much more severe than traditional HA-MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome, and necrotizing ("flesh-eating") pneumonia. This is thought to be due to toxins carried by CA-MRSA strains, such as PVL and PSM, though PVL was recently found not to be a factor in a study by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. It is not known why some healthy people develop CA-MRSA skin infections that are treatable while others infected with the same strain develop severe infections or die.[7]
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
All doctor whom I ask say that CA MRSA with PSM toxin develop very fast like septic shock for people with health problems like weak immune system, and immune system defects.
But others will start with skin infection that if is early diagnosed and proper treated will no cause invasive blood stream infection.
As all doctors agree wit that there should be written that in literature, but I cant find that.
Can you please – find this statement in literature and send me !!
So I can read it !!
Thank you very much.
Hello !!
I have question about CA MRSA that can develop very fast – and cause severe invasive blood stream infections like septic shock.
Some CA-MRSA strains display enhanced virulence, spreading more rapidly and causing illness much more severe than traditional HA-MRSA infections, and they can affect vital organs and lead to widespread infection (sepsis), toxic shock syndrome, and necrotizing ("flesh-eating") pneumonia. This is thought to be due to toxins carried by CA-MRSA strains, such as PVL and PSM, though PVL was recently found not to be a factor in a study by the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. It is not known why some healthy people develop CA-MRSA skin infections that are treatable while others infected with the same strain develop severe infections or die.[7]
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
All doctor whom I ask say that CA MRSA with PSM toxin develop very fast like septic shock for people with health problems like weak immune system, and immune system defects.
But others will start with skin infection that if is early diagnosed and proper treated will no cause invasive blood stream infection.
As all doctors agree wit that there should be written that in literature, but I cant find that.
Can you please – find this statement in literature and send me !!
So I can read it !!
Thank you very much.
Brief Answer:
I don't believe you would find such a statement
Detailed Answer:
Hello,
Phenol-Soluble Modulin (PSM) is a new concept in research and not very well documented as Panton-Valentine Leucocidin (PVL). Staphylococcus in general may cause trouble to patients with immune system defects and of course weak immune systems that suffer a staphylococcal infection are in a dire position because they can't fight efficiently the powerful pathogen.
Taking the above into account I believe that the doctors that you've talked to, were not talking about PSM in specific.
I did a fast search anyway both in the internet and in the most admired infectious diseases textbook (and recent - this year's edition, Mandell-Douglas) and have found no clinical information about it - just the details of PSM action, but no reference to the state of the host's immune system.
I hope I've helped you with that!
Contact me again, if you'd like any clarification.
Kind Regards!
I don't believe you would find such a statement
Detailed Answer:
Hello,
Phenol-Soluble Modulin (PSM) is a new concept in research and not very well documented as Panton-Valentine Leucocidin (PVL). Staphylococcus in general may cause trouble to patients with immune system defects and of course weak immune systems that suffer a staphylococcal infection are in a dire position because they can't fight efficiently the powerful pathogen.
Taking the above into account I believe that the doctors that you've talked to, were not talking about PSM in specific.
I did a fast search anyway both in the internet and in the most admired infectious diseases textbook (and recent - this year's edition, Mandell-Douglas) and have found no clinical information about it - just the details of PSM action, but no reference to the state of the host's immune system.
I hope I've helped you with that!
Contact me again, if you'd like any clarification.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I was talking with doctors about PSM – and they said that it is not risk for healthy people !!
About PVL is publication that it is not so virulent !!
t PVL-positive S. aureus strains are not inherently more virulentthan PVL-negativ
http://www.health.wa.gov.au/circularsnew/circular.cfm?Circ_ID=13012
I just wanted to understand an read publication about PSM – and about it virulent, but as you said there is not research yet about it virulent !
There is one publication
but it is to difficult - for me !!
maybe you understand
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/
it is about PSM toxin !!
Could you explain little bit about that ??
So you say like other doctors – if I m healthy – I should not stress about CA MRSA with PSM
And should not find info in internet ??
Brief Answer:
I've skimmed through both documents, please read the full answer
Detailed Answer:
Hi,
Regarding PVL: it seems that PVL positive strains cause an increased morbidity in skin/soft tissue infections and they may cause the severe hemorrhagic pneumonia in children and young adults.
PSM interacts with the biofilm accelerating staphylococcus spread to other sites.
Another action on the host is lysis of the neutrophils (some of the cells that fight against infection).
The article you've linked, describes the pathogenesis related to PSM (what I've presented you in the lines above).
You can't be stressed about staphylococcus or any pathogen, unless you've got a specific reason to do so, like immune system defects, recurrent infections etc
And you're not likely to find more information on the internet (at least I didn't!) besides the things about pathogenesis that I've already mentioned.
Kind Regards!
I've skimmed through both documents, please read the full answer
Detailed Answer:
Hi,
Regarding PVL: it seems that PVL positive strains cause an increased morbidity in skin/soft tissue infections and they may cause the severe hemorrhagic pneumonia in children and young adults.
PSM interacts with the biofilm accelerating staphylococcus spread to other sites.
Another action on the host is lysis of the neutrophils (some of the cells that fight against infection).
The article you've linked, describes the pathogenesis related to PSM (what I've presented you in the lines above).
You can't be stressed about staphylococcus or any pathogen, unless you've got a specific reason to do so, like immune system defects, recurrent infections etc
And you're not likely to find more information on the internet (at least I didn't!) besides the things about pathogenesis that I've already mentioned.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So As I understand If I m healthy – I wont have rapid CA MRSA invasive severe blood stream infection from PSM toxin .
And if cured in time soon as possible I will avoid any trouble.
And as I understand 75 % of CA MRSA are skin infections – that are those who are hospitalized. Is it so ??
About 75 percent of community-associated (CA-) MRSA infections are localized to skin and soft tissue and usually can be treated effectively.
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus
Thank you for you help !!!
Brief Answer:
You're welcome
Detailed Answer:
I cannot confirm whether 75% applies everywhere but I'm sure this is a fair estimation globally.
Prompt treatment is not always successful but it's better than late or no treatment.
I'll be glad to help again in the future, if you'd need to ask!
Kind Regards!
You're welcome
Detailed Answer:
I cannot confirm whether 75% applies everywhere but I'm sure this is a fair estimation globally.
Prompt treatment is not always successful but it's better than late or no treatment.
I'll be glad to help again in the future, if you'd need to ask!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
About you anwer !!
Prompt treatment is not always successful but it's better than late or no treatment.
As I have read in all literature - it is said that in CA MRSA skin infection it is very importan to treat erly as posible !!
and ca mrsa skin infections are treated suscesfuly, im not taking abou blood stream infection.
and about this qestion
So As I understand If I m healthy – I wont have rapid CA MRSA invasive severe blood stream infection from PSM toxin .
is it true ??
Prompt treatment is not always successful but it's better than late or no treatment.
As I have read in all literature - it is said that in CA MRSA skin infection it is very importan to treat erly as posible !!
and ca mrsa skin infections are treated suscesfuly, im not taking abou blood stream infection.
and about this qestion
So As I understand If I m healthy – I wont have rapid CA MRSA invasive severe blood stream infection from PSM toxin .
is it true ??
Brief Answer:
Yes/Could be
Detailed Answer:
Hi,
perhaps I did not explain that properly. Proper and correct treatment is obviously effective regarding skin infections. Sometimes skin infections are undertreated though and that was what I was referring too.
You can't be absolutely certain that you won't have invasive staphylococcal infection, whether you're healthy or not. It is just that being healthy guaranties that your body will fight infection as much as possible. Healthy people may suffer serious infections (and potentially fatal ones too) from staphylococcus or other pathogens. Regarding PSM in particular, since it's not a very well documented finding, I cannot actually answer and still be scientifically accurate. I suppose we'll know more in the future!
Kind Regards!
Yes/Could be
Detailed Answer:
Hi,
perhaps I did not explain that properly. Proper and correct treatment is obviously effective regarding skin infections. Sometimes skin infections are undertreated though and that was what I was referring too.
You can't be absolutely certain that you won't have invasive staphylococcal infection, whether you're healthy or not. It is just that being healthy guaranties that your body will fight infection as much as possible. Healthy people may suffer serious infections (and potentially fatal ones too) from staphylococcus or other pathogens. Regarding PSM in particular, since it's not a very well documented finding, I cannot actually answer and still be scientifically accurate. I suppose we'll know more in the future!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
About your answer
You can't be absolutely certain that you won't have invasive staphylococcal infection, whether you're healthy or not. It is just that being healthy guaranties that your body will fight infection as much as possible. Healthy people may suffer serious infections (and potentially fatal ones too) from staphylococcus or other pathogens.
How do you mean that ? that healthy people who get in hospital and develop blood stream infection from colonized CA MRSA?
I m healthy athlete
Of course also healthy people can get blood stream infection if they are colonized with CA MRSA and get surgery – or get in some accident and get in hospital they are high risk of MRSA blood stream infection.
But I m talking about normal healthy person who is colonized with CA MRSA and get some CA MRSA skin infection from small skin cut.
As all doctors who consulted me ( also infectologist) said that healthy people will not cause rapid fatal septic shock from MRSA, but can develop it as blood stream infection if not proper treated in time.
In risk of septic shock are people with immune system defects (who seems to be healthy, but have some immune system defect) and those with weak immune system.
So do you agree with them ??
Brief Answer:
I do agree
Detailed Answer:
Hi,
you've asked in a rather 'absolute' way. That's why I've answered like that. The truth is that as all doctors seem to have told you (including me), the immune system condition plays a major role in infectious diseases outcome. Despite that, a good immune system won't guaranty a 100% good outcome.
A bad outcome on the other hand is much more common when immune system defects exist, which may indeed be unknown till then.
So I'm basically saying the same thing. Being healthy definitely makes you stronger against infections.
Kind Regards!
I do agree
Detailed Answer:
Hi,
you've asked in a rather 'absolute' way. That's why I've answered like that. The truth is that as all doctors seem to have told you (including me), the immune system condition plays a major role in infectious diseases outcome. Despite that, a good immune system won't guaranty a 100% good outcome.
A bad outcome on the other hand is much more common when immune system defects exist, which may indeed be unknown till then.
So I'm basically saying the same thing. Being healthy definitely makes you stronger against infections.
Kind Regards!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
