Persistent methicillin-resistant Staphylococcus aureus bacteremia owing to placental abscess

Naomi Maeda, Hideharu Hagiya, Tsuyoshi Takiuchi, Shinsuke Kusakabe, Tetsuo Maeda, Keigo Kimura, Sayuri Iwai, Keisuke Kawasaki, Yumiko Hori, Eiichi Morii, Yuzuru Kanakura, Tadashi Kimura, Kazunori Tomono

Research output: Contribution to journalArticle

Abstract

Staphylococcus aureus as a pathogen in human gestational membranes, a rather rare phenomenon, has recently been the focus of several researches. S. aureus forms biofilms on these membranes and potentially causes chorioamnionitis in pregnant women. We report a case of persistent methicillin-resistant S. aureus (MRSA) bacteremia owing to placental infection, causing chorioamnionitis and preterm birth. A 29-year-old Japanese woman at the 27th gestational week was diagnosed with acute promyelocytic leukemia and underwent all-trans retinoic acid therapy. Soon after hospitalization, the patient presented with persistent MRSA bacteremia of unknown origin. Despite various antimicrobial therapies, she experienced 12 MRSA bacteremia episodes over 6 weeks. However, after child birth, MRSA bacteremia disappeared without any complications. A pathologic examination of her placenta revealed placenta abscess, resulting in a diagnosis of MRSA-associated chorioamnionitis. Molecular analysis proved that a single MRSA strain (SCCmec Type IVa), which tested negative for Panton–Valentine leukocidin and toxic shock syndrome toxin-1, caused the obstinate infection. We should be aware that persistent MRSA bacteremia in pregnant women can originate from placental abscess.

Original languageEnglish
Pages (from-to)975-979
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume24
Issue number12
DOIs
Publication statusPublished - Dec 2018
Externally publishedYes

Keywords

  • Chorioamnionitis
  • Febrile neutropenia
  • Leukemia
  • Methicillin-resistant Staphylococcus aureus
  • Persistent bacteremia
  • Staphylococcus aureus bacteremia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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  • Cite this

    Maeda, N., Hagiya, H., Takiuchi, T., Kusakabe, S., Maeda, T., Kimura, K., Iwai, S., Kawasaki, K., Hori, Y., Morii, E., Kanakura, Y., Kimura, T., & Tomono, K. (2018). Persistent methicillin-resistant Staphylococcus aureus bacteremia owing to placental abscess. Journal of Infection and Chemotherapy, 24(12), 975-979. https://doi.org/10.1016/j.jiac.2018.05.001