Serious postpartum infection due to MRSA in an asymptomatic carrier: case report and review.
Infection with methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide problem and is no longer acquired only in a hospital setting. Community-associated MRSA is an emerging pathogen of increasing interest to both obstetricians and neonatologists, reported in all three trimesters of pregnancy and postpartum, and in neonatal intensive care units, leading to severe outcomes, including neonatal death. This case report describes a serious and potentially life-threatening infection (including wound abscess, septicemia, septic thrombophlebitis, and septic pulmonary emboli) that developed in an otherwise healthy postpartum woman who had screened positive for MRSA in nares, vagina, and rectum at the time of her prior admission in labor as part of a research study. We conclude that asymptomatic nasal, vaginal, and rectal colonization with MRSA occurs in pregnancy and may be a risk factor for serious systemic infection after delivery.
Department of Obstetrics and Gynecology, Newark Beth Israel Medical Center, Newark, New Jersey, USA.
Paul G
PG
Stumpf
Marisol
M
Flores
Jeremias
J
Murillo
D000038:Abscess / Q000382:microbiology / Q000601:surgery / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002353:Carrier State / Q000382:microbiology; D002585:Cesarean Section / Q000009:adverse effects*; D015377:Cilastatin / Q000627:therapeutic use; D000077728:Cilastatin, Imipenem Drug Combination; D004322:Drainage; D004338:Drug Combinations; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D011247:Pregnancy; D011645:Puerperal Infection / Q000188:drug therapy / Q000382:microbiology*; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D011859:Radiography; D018805:Sepsis / Q000188:drug therapy / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology*; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology; D014640:Vancomycin / Q000627:therapeutic use; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D004338:Drug Combinations; D015377:Cilastatin; D014640:Vancomycin; D015378:Imipenem; D006493:Heparin; D000077728:Cilastatin, Imipenem Drug Combination