Methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis of the mandible.
Methicillin-resistant Staphylococcus aureus (MRSA) is a type of Staphylococcus that is resistant to certain antibiotics, such as methicillin, oxacillin, penicillin, and amoxicillin. This nosocomial pathogen has become a great threat in hospitals globally. Up to 40% of the normal population carries S. aureus in the anterior nares, and this rate is often higher in hospitalized patients and their attendants. This case report presents a patient with serious MRSA osteomyelitis of the mandible demonstrating purulent discharge. The patient failed to recover despite prolonged postoperative treatment and the administration of several antibiotics. There was a resulting nonunion along with chronic MRSA infection. The treatment protocol involved a multimodal approach with parenteral clindamycin infusion, local rifampicin irrigation, and intermaxillary fixation of the jaws.
Tuzuner-Oncul
Aysegul Mine
AM
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara University, Ankara, Turkey. ayltuzuner@yahoo.com
Ungor
Cem
C
Dede
Utku
U
Kisnisci
Reha S
RS
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001860:Bone Plates / Q000009:adverse effects*; D002981:Clindamycin / Q000627:therapeutic use; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D036502:Infusions, Intralesional; D008297:Male; D008336:Mandibular Diseases / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D008337:Mandibular Fractures / Q000150:complications / Q000628:therapy; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D010019:Osteomyelitis / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D012086:Reoperation; D012293:Rifampin / Q000008:administration & dosage; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D012293:Rifampin