Effective antibiotic treatment of methicillin-resistant Staphylococcus aureus-associated glomerulonephritis.
BACKGROUND
A new type of glomerulonephritis following a methicillin-resistant Staphylococcus aureus (MRSA) infection has been reported. The purpose of this study is to elucidate the clinicopathological features and the responsiveness to treatment of the disease.


METHODS
We studied the treatment of 8 patients with glomerulonephritis related to MRSA infection. We observed the eight cases and analyzed clinical features, laboratory findings and histopathological data.


RESULTS
On admission, all patients had no renal abnormalities. One to four months after suffering from MRSA infection, severe proteinuria and hematuria developed. Renal biopsy specimens revealed moderate to severe mesangial proliferative glomerulonephritis with various degrees of crescent formation. Immunofluorescence studies showed IgA and C3. Antibiotic therapy was performed in six cases, resulting in successfully reducing the proteinuria in parallel with the decreased activity of MRSA infection in five cases. The other 2 cases received corticosteroid treatment after complete cessation of MRSA infection, but they had a relapse of MRSA infection and later died from sepsis.


CONCLUSIONS
These results suggested that MRSA-associated glomerulonephritis might respond to antibiotic treatment in most cases. This also indicated that special care must be taken in the application of steroid therapy for the glomerulonephritis with crescents, even though the MRSA infection has gone into an inactive state.
Nagaba
Yasushi
Y
Department of Internal Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara City, Kanagawa 228-8555, Japan. yanagaba@med.kitasato-u.ac.jp
Hiki
Yoshiyuki
Y
Aoyama
Togo
T
Sano
Takashi
T
Matsuo
Takatoshi
T
Shimizu
Takeshi
T
Tateno
Sumio
S
Sakamoto
Hisato
H
Kamata
Kouju
K
Shigematsu
Hidekazu
H
Higashihara
Masaaki
M
Kobayashi
Yutaka
Y
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000187:drug effects*
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents