title: European ST80 community-associated methicillin-resistant Staphylococcus aureus orbital cellulitis in a neonate.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus is a serious cause of morbidity and mortality in hospital environment, but also, lately, in the community. This case report is, to our knowledge, the first detailed description of a community-associated methicillin-resistant S. aureus ST80 orbital cellulitis in a previously healthy neonate. Possible predisposing factors of microbial acquisition and treatment selection are also discussed.
  
  
  METHODS
  A 28-day-old Caucasian boy was referred to our hospital with the diagnosis of right orbital cellulitis. His symptoms included right eye proptosis, periocular edema and redness. Empirical therapy of intravenous daptomycin, rifampin and ceftriaxone was initiated. The culture of pus yielded a methicillin-resistant S. aureus isolate and the molecular analysis revealed that it was a Panton-Valentine leukocidine-positive ST80 strain. The combination antimicrobial therapy was continued for 42 days and the infection was successfully controlled.
  
  
  CONCLUSIONS
  Clinicians should be aware that young infants, even without any predisposing condition, are susceptible to orbital cellulitis caused by community-associated methicillin-resistant S. aureus. Prompt initiation of the appropriate empirical therapy, according to the local epidemiology, should successfully address the infection, preventing ocular and systemic complications.
authors.affiliation: Department of Ophthalmology, University General Hospital of Larissa, University of Thessaly, Medical School Biopolis, Larissa 41110, Greece.
authors.forename: Evangelia E
authors.initials: EE
authors.lastname: Tsironi
authors.forename: Fani
authors.initials: F
authors.lastname: Zacharaki
authors.forename: Ioanna N
authors.initials: IN
authors.lastname: Grivea
authors.forename: Sophia V
authors.initials: SV
authors.lastname: Tachmitzi
authors.forename: Aspasia N
authors.initials: AN
authors.lastname: Michoula
authors.forename: Marianna
authors.initials: M
authors.lastname: Vlychou
authors.forename: Efthimia
authors.initials: E
authors.lastname: Petinaki
authors.forename: George A
authors.initials: GA
authors.lastname: Syrogiannopoulos
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000382:microbiology; D004359:Drug Therapy, Combination; D006115:Greece; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D054517:Orbital Cellulitis / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents