Invasive Community-Acquired Methicillin-Resistant Staphylococcus aureus in a Japanese Girl with Disseminating Multiple Organ Infection: A Case Report and Review of Japanese Pediatric Cases

Table 1

The review of Japanese pediatric cases with severe CA-MRSA infection.

	Case	Case	Our case
Age	16-month-old boy	24-month-old boy	23-month-old girl
Reported year	2006	2013	2014
Meningitis	−	−	+
Necrotizing pneumonia	+	+	+
Urinary tract infection	−	−	+
Osteomyelitis	−	−	+
Fasciitis	−	−	+
Bacteremia	+	NA	+
Septic shock	+	+	−
Panton-Valentine leucocidin (PVL)	+	+	+
Cassette chromosome mec (SCC mec)	IVa	NA	IVa
Staphylococcal enterotoxins	g (+); seu (+)	NA	seb (+)
Arginine catabolic mobile element (ACME)	Negative	NA	Negative
Initial antimicrobials	SBT/ABPC  + CTX	ABPC	CTX
Antimicrobials after MRSA determined	VCM + MEPM	Already dead	VCM/LZD + MEPM
Outcome	Died	Died	Survived

g, enterotoxin gene cluster, including seg, sei, sem, sen, and seo genes.
SBT/ABPC, sulbactam/ampicillin; CTX, cefotaxime; MEPM, meropenem; LZD, linezolid; VCM, vancomycin.