Khalid Muhammad, Junejo Samina, Mir Fatima
Department of Pediatric Infectious Diseases, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2018 Sep;28(9):S174-S177. doi: 10.29271/jcpsp.2018.09.S174.
Staphylococci are gram-positive bacteria divided into coagulase positive and coagulase negative classes, Staphylococcus aureus is the most important bacterium of this class. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has changed a lot. It is no more the problem of only hospitalised patients. Children coming from community has also been increasingly affected by MRSA-called community acquired methicillin-resistant (CA-MRSA) infection. The higher severity of CA-MRSA is due to its ability to produce the toxin Panton-Valentine Leukocidin (PVL) associated with staphylococcal cassette chromosome mec (SCCmec) type IV gene. Here, we are presenting five cases of CA-MRSA infection in children having age range 0.5 months to 11 years. All of them had invasive MRSA infection finally diagnosed as causing empyema thoracis, infective endocarditis, psoas abscess and necrotising fasciitis. Early surgical intervention, quick microbiological recognition of the pathogen, and appropriate antimicrobial therapy helped save their lives.
葡萄球菌是革兰氏阳性菌,分为凝固酶阳性和凝固酶阴性两类,金黄色葡萄球菌是此类中最重要的细菌。耐甲氧西林金黄色葡萄球菌(MRSA)的流行病学已发生了很大变化。它不再只是住院患者的问题。来自社区的儿童也越来越多地受到MRSA感染,即所谓的社区获得性耐甲氧西林(CA-MRSA)感染。CA-MRSA的严重性更高是由于其产生与葡萄球菌盒式染色体mec(SCCmec)IV型基因相关的杀白细胞毒素(PVL)的能力。在此,我们呈现5例年龄在0.5个月至11岁之间儿童的CA-MRSA感染病例。他们均患有侵袭性MRSA感染,最终诊断为导致脓胸、感染性心内膜炎、腰大肌脓肿和坏死性筋膜炎。早期手术干预、对病原体的快速微生物学识别以及适当的抗菌治疗帮助挽救了他们的生命。