Enterocolitis Caused by Methicillin-Resistant Staphylococcus aureus

Abstract

Infectious diarrhea is a well-known cause of morbidity and mortality in hospitalized patients. The most common cause of infectious diarrhea is Clostridium difficile-associated diarrhea. Other common causes include Clostridium perfringens and Staphylococcus aureus. Staphylococcal enterocolitis associated with antibiotic administration was first described in 1948, but recognition of this phenomenon has waned. Methicillin-resistant S. aureus (MRSA) is an increasingly common cause of hospital-acquired infection that also leads to significant morbidity and mortality among hospitalized patients. There are few reports in the English literature of MRSA enterocolitis. We report 2 cases of enterocolitis caused by MRSA, successfully treated with oral vancomycin. The diagnosis was made on distinctive Gram stain appearance of fecal smears along with a heavy growth of MRSA from stool cultures in the absence of the other bowel pathogens including toxigenic C. difficile.