Yonezawa Ryuta, Kuwana Tsukasa, Kawamura Kengo, Inamo Yasuji
Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.
Case Rep Pediatr. 2015;2015:291025. doi: 10.1155/2015/291025. Epub 2015 Dec 27.
Pediatric invasive community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is very serious and occasionally fatal. This infectious disease is still a relatively rare and unfamiliar infectious disease in Japan. We report a positive outcome in a 23-month-old Japanese girl with meningitis, osteomyelitis, fasciitis, necrotizing pneumonia, urinary tract infection, and bacteremia due to CA-MRSA treated with linezolid. PCR testing of the CA-MRSA strain was positive for PVL and staphylococcal enterotoxin b and negative for ACME. SCC mec was type IVa. This case underscores the selection of effective combinations of antimicrobial agents for its treatment. We need to be aware of invasive CA-MRSA infection, which rapidly progresses with a serious clinical course, because the incidence of the disease may be increasing in Japan.
儿童侵袭性社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)感染非常严重,偶尔会致命。这种传染病在日本仍然是一种相对罕见且不为人熟悉的传染病。我们报告了一名23个月大的日本女孩因CA-MRSA感染导致脑膜炎、骨髓炎、筋膜炎、坏死性肺炎、尿路感染和菌血症,使用利奈唑胺治疗后取得了良好疗效。对该CA-MRSA菌株进行PCR检测,结果显示Panton-Valentine杀白细胞素(PVL)和葡萄球菌肠毒素b呈阳性,ACME呈阴性。葡萄球菌染色体盒式Mec(SCC mec)为IVa型。该病例强调了选择有效的抗菌药物联合治疗的重要性。我们需要警惕侵袭性CA-MRSA感染,其临床病程严重且进展迅速,因为在日本这种疾病的发病率可能正在上升。