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シモヤマ キヨウヘイ
Shimoyama Kiyouhei
下山 恭平 所属 医学部 医学科（附属八千代医療センター） 職種 助教 |
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| 論文種別 | 症例報告 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Panton-Valentine leukocidin-positive novel sequence type 5959 community-acquired methicillin-resistant Staphylococcus aureus meningitis complicated by cerebral infarction in a 1-month-old infant. |
| 掲載誌名 | 正式名：Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 略 称：J Infect Chemother ISSNコード：14377780/1341321X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 27(1),pp.103-106 |
| 著者・共著者 | Nozomu Oshima, Hiromichi Hamada, Shoko Hirose, Kyohei Shimoyama, Makoto Fujimori,
Takafumi Honda, Kumi Yasukawa, Naruhiko Ishiwada, Misako Ohkusu, Jun-ichi Takanashi |
| 発行年月 | 2021/01 |
| 概要 | Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has become a pathogen of major importance in pediatric patients. CA-MRSA can cause skin and soft tissue infection in children and young active adults with no predisposing factors, and life-threatening infections such as meningitis or necrotizing pneumonia have been reported. We report here a case of CA-MRSA meningitis complicated by acute left middle cerebral artery (MCA) infarction and necrotizing pneumonia in a previously healthy 1-month-old Vietnamese boy. He was firstly treated with vancomycin, but changed to linezolid because of persistent fever and low vancomycin trough level. He recovered successfully with residual right-sided hemiparesis. The mode of transmission of CA-MRSA and the mechanism of cerebral infarction (thrombotic or embolic) were unknown. The isolate was genotyped as staphylococcal cassette chromosome (SCC) mec type V with a novel sequence type (ST) 5959 harboring the Panton-Valentine leukocidin (PVL) gene. ST 5959 is a double locus variant of ST 59, which is a major PVL-positive CA-MRSA strain isolated in invasive disease in Asian countries. This case report may serve as a warning about the dissemination of PVL-positive CA-MRSA in and around Japan, with the possibility of causing serious life-threatening disease. The potential of linezolid for the treatment of MRSA meningitis as one of the alternative MRSA therapeutic drugs is also discussed. |
| DOI | 10.1016/j.jiac.2020.09.011 |
| PMID | 32988732 |