title: Infection with methicillin-resistant Staphylococcus aureus after carbon dioxide resurfacing of the face. Successful treatment with minocycline, rifampin, and mupiricin ointment.
abstract: BACKGROUND
  The incidence of cutaneous bacterial infection after carbon dioxide (CO2 laser resurfacing is increasing. Patients with staphylococcal colonization of their anterior nares may be at greater risk for postoperative cutaneous colonization and/or infection, which can potentially cause scarring.
  
  
  OBJECTIVE
  We present a case report of methicillin-resistant Staphylococcus aureus secondary infection of the skin after CO2 laser resurfacing. We discuss the possible etiologies of this patient's infection, her postoperative management, and preoperative suggestions for possibly preventing infection.
  
  
  METHODS
  A 49-year-old woman was treated with CO2 laser resurfacing for moderate actinic damage and facial rhytides. She developed a cutaneous infection with methicillin-resistant S. aureus, which caused diffuse linear scarring on her cheeks and upper lip.
  
  
  RESULTS
  The patient was successfully treated with oral minocycline, rifampin, and topical mupiricin ointment to her cutaneous erosions.
  
  
  CONCLUSIONS
  We propose that it would be helpful for patients undergoing CO2 laser resurfacing to have their nares cultured to see if they are staphylococcal carriers. If a patient is found to be a carrier, mupiricin ointment can be used preoperatively treat to the nares, to help decrease the risk of infection of the skin from this potential source.
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Florida, USA.
authors.forename: B
authors.initials: B
authors.lastname: Bellman
authors.forename: F S
authors.initials: FS
authors.lastname: Brandt
authors.forename: M
authors.initials: M
authors.lastname: Holtmann
authors.forename: W R
authors.initials: WR
authors.lastname: Bebell
mesh_terms: D062109:Dermatologic Surgical Procedures; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005148:Facial Dermatoses / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D016106:Methicillin Resistance; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage; D016712:Mupirocin / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage; D015595:Skin Aging; D017192:Skin Diseases, Bacterial / Q000188:drug therapy* / Q000209:etiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000209:etiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013518:Surgery, Plastic / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology
chemical_list: D016712:Mupirocin; D008911:Minocycline; D012293:Rifampin