title: Molecular characterization of methicillin-resistant Staphylococcus aureus from a fatal case of necrotizing fasciitis in an extremely low-birth-weight infant.
abstract: Necrotizing fasciitis due to methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon but life-threatening infection, and has mainly been reported as occurring in adults and the elderly. Recently, infant cases involving Panton-Valentine leukocidin (PVL)-positive community-acquired MRSA have been noted. Here, a case of fatal necrotizing fasciitis with sepsis and disseminated intravascular coagulation in an extremely low-birth-weight infant is described. The causative agent was the hospital-acquired MRSA New York/Japan clone carrying the spa variant gene and nine staphylococcal enterotoxin (SE) genes. These data suggest that a high-level combination of SEs and other virulence factors, but not PVL, could contribute to the pathogenesis of fatal necrotizing fasciitis.
authors.affiliation: Department of Paediatirics, Gifu Prefectural General Medical Centre, Gifu, Japan.
authors.forename: K O
authors.initials: KO
authors.lastname: Orii
authors.forename: Y
authors.initials: Y
authors.lastname: Iwao
authors.forename: W
authors.initials: W
authors.lastname: Higuchi
authors.forename: T
authors.initials: T
authors.lastname: Takano
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000382:microbiology; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004211:Disseminated Intravascular Coagulation / Q000382:microbiology; D004768:Enterotoxins / Q000235:genetics; D019115:Fasciitis, Necrotizing / Q000150:complications / Q000382:microbiology*; D017809:Fatal Outcome; D005838:Genotype; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008969:Molecular Sequence Data; D018805:Sepsis / Q000382:microbiology; D017422:Sequence Analysis, DNA; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology*; D013205:Staphylococcal Protein A / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; D004768:Enterotoxins; D013205:Staphylococcal Protein A; D037521:Virulence Factors