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6 岁女童耐甲氧西林金黄色葡萄球菌多部位感染:病例报告。

Multi-site infection by methicillin-resistant Staphylococcus aureus in a six-year old girl: a case report.

机构信息

Department of Pediatric Emergency Medicine and Critical Care Medicine, Children's Hospital of Fudan University, Shanghai, China.

Department of Laboratory Medicine, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

BMC Infect Dis. 2022 Mar 3;22(1):210. doi: 10.1186/s12879-022-07148-1.

Abstract

BACKGROUND

Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen that leads to severe outcomes, especially in pediatric patients with multiple sites infection.

CASE PRESENTATION

We report a case of multiple sites and life-threatening infection caused by CA-MRSA in a 6-year-old girl who manifested sepsis, myelitis, purulent arthritis, purulent meningitis, hydropericardium, pneumonia, and empyema. The girl exhibited good response to the combination therapy of linezolid and rifampicin after treatment failure of vancomycin with maximum dose due to its serum concentration unable to reach therapeutic goal. We performed pleural effusion and hydropericardium effusion drainage and treated left lower limb infection using interdisciplinary approaches.

CONCLUSION

This case highlights the need to be aware of CA-MRSA infection, which requires accurate diagnosis, identification of infected sites, appropriate antibiotic treatment, and surgical debridement.

摘要

背景

社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)是一种新兴的病原体,可导致严重后果,尤其是在有多部位感染的儿科患者中。

病例介绍

我们报告了一例 6 岁女孩多部位、危及生命的 CA-MRSA 感染病例,该患儿表现为脓毒症、脊髓炎、化脓性关节炎、化脓性脑膜炎、心包积脓、肺炎和脓胸。该女孩在最大剂量万古霉素治疗因血清浓度无法达到治疗目标而失败后,对利奈唑胺和利福平联合治疗反应良好。我们采用多学科方法进行了胸腔积液和心包积脓引流,并对左下肢感染进行了治疗。

结论

本病例强调了需要注意 CA-MRSA 感染,这需要准确的诊断、确定感染部位、适当的抗生素治疗和手术清创。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6a3/8895610/eecd365e4f61/12879_2022_7148_Fig1_HTML.jpg

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