Abstract

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emergent pathogen in Brazil. However, there are no data on the prevalence of CA-MRSA. We report here the first well-characterized case of severe life-threatening CA-MRSA infection in a child living in Rio de Janeiro city. The patient had many complications including hematogenous osteomyelitis and involvement of multiple sites requiring drainage of soft-tissue abscess, and pleural and pericardial empyema. The MRSA isolates recovered were genotyped using PFGE, SCCmec typing and multilocus sequence typing. Disk diffusion tests were performed following Clinical and Laboratory Standards Institute recommendations. In addition, the presence of Panton-Valentine leukocidin (PVL) was assessed by PCR amplification, using specific primers for lukF-pv (encoding for the F subunit of the PVL). The bacterial isolates were related to the ST30-SCCmecIV lineage (Oceania Southwest Pacific clone), a PVL producer CA-MRSA previously detected in Porto Alegre, RS, Brazil. Also, the isolates analyzed were susceptible to all non-beta-lactam antibiotics tested. The present report demonstrates that disseminated CA-MRSA disease is also occurring in Rio de Janeiro. Thus, the empirical treatment of moderate or severe infections suspected of being associated with CA-MRSA needs to be reviewed in order to allow prompt initiation of an effective therapy that also covers these microorganisms.

Highlights

  • Community-acquired infections by methicillin-resistant Staphylococcus aureus (CA-MRSA) are emerging diseases with increasing incidence worldwide [1]

  • The bacterial isolates were related to the ST30-Staphylococcal Cassette Chromosome mec (SCCmec) IV lineage (Oceania Southwest Pacific clone), a Panton-Valentine leukocidin (PVL) producer CA-MRSA previously detected in Porto Alegre, RS, Brazil

  • CA-MRSA infections are currently emerging in Brazil, posing a challenge in terms of diagnosis and initiation of effective therapy in order to reduce morbidity and mortality

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Summary

CLINICAL INVESTIGATION

The first report in Brazil of severe infection caused by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).

Short Communication
Introduction
Patient and Methods
Results
MRSA characterization All MRSA isolates obtained carried the SCCmec type
Discussion
Full Text
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