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2018

ANUÁRIO DO HOSPITAL DONA ESTEFÂNIA
REPOSITÓRIO MÉDICO CIENTÍFICO

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COMMUNITY-ASSOCIATED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS LACKING PVL, AS A CAUSE OF SEVERE INVASIVE INFECTION TREATED WITH LINEZOLID - CASE REPORT

Catarina Gouveia1, Alexandra Gavino1, Ons Bouchami2, Maria Miragaia2,Luis Varandas1, Herminia de Lencastre2,3, Maria João Brito1

1 Infectious Diseases Unit, Pediatric Department, Dona Estefˆania Hospital, CHLC, Jacinta Marto Street, 1169-045 Lisbon, Portugal
2 Laboratorio de Gen´etica Molecular, Instituto de Tecnologia Qu´ımica e Biol´ogica (ITQB), Universidade Nova de Lisboa, Rua da Quinta Grande,No. 6, 2780-156 Oeiras, Portugal
3 Laboratory of Microbiology,The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA

Case Reports in Pediatrics. Volume 2013, Article ID 727824, 5 pages
http://dx.doi.org/10.1155/2013/727824

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging public health problem worldwide.
Severe invasive infections have been described, mostly associated with the presence of Panton-Valentine leukocidin (PVL). In Portugal limited information exists regarding CA-MRSA infections. In this study we describe the case of a previously healthy 12-year-old female, sport athlete, who presented to the hospital with acetabulofemoral septic arthritis, myositis, fasciitis, acetabulum osteomyelitis, and pneumonia.TheMRSA isolated fromblood and synovial fluidwas PVL negative and staphylococcal enterotoxin type P (SEP) and type L (SEL) positive, with a vancomycin MIC of 1.0mg/L and resistant to clindamycin and ciprofloxacin. The patient was submitted tomultiple surgical drainages and started on vancomycin, rifampicin, and gentamycin. Due to persistence of fever and no microbiological clearance, linezolid was started with improvement. This is one of the few reported cases of severe invasive infection caused byCA-MRSA in Portugal,whichwas successfully treated with linezolid. In spite of the severity of infection, the MRSA isolate did not produce PVL.