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Am J Perinatol 2008; 25(7): 413-415
DOI: 10.1055/s-2008-1075032
© Thieme Medical Publishers

Serious Postpartum Infection Due to MRSA in an Asymptomatic Carrier: Case Report and Review

Paul G. Stumpf1 , Marisol Flores1 , Jeremias Murillo2
  • 1Department of Obstetrics and Gynecology, Newark Beth Israel Medical Center, Newark, New Jersey
  • 2Division of Infectious Diseases, Newark Beth Israel Medical Center, Newark, New Jersey
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Publication History

Publication Date:
04 June 2008 (online)

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ABSTRACT

Infection with methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide problem and is no longer acquired only in a hospital setting. Community-associated MRSA is an emerging pathogen of increasing interest to both obstetricians and neonatologists, reported in all three trimesters of pregnancy and postpartum, and in neonatal intensive care units, leading to severe outcomes, including neonatal death. This case report describes a serious and potentially life-threatening infection (including wound abscess, septicemia, septic thrombophlebitis, and septic pulmonary emboli) that developed in an otherwise healthy postpartum woman who had screened positive for MRSA in nares, vagina, and rectum at the time of her prior admission in labor as part of a research study. We conclude that asymptomatic nasal, vaginal, and rectal colonization with MRSA occurs in pregnancy and may be a risk factor for serious systemic infection after delivery.

KEYWORDS

MRSA - methicillin-resistant Staphylococcus aureus - CA-MRSA - community-acquired methicillin-resistant Staphylococcus aureus - pregnancy - postpartum - infection - sepsis

REFERENCES

  • 1 Laibl V R, Sheffield J S, Roberts S, McIntire D D, Trevino S, Wendel Jr G D. Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy.  Obstet Gynecol. 2005;  106 461-465
    CrossrefPubMedSearch in Google Scholar
  • 2 Saiman L, O'Keefe M, Graham III P L et al.. Hospital transmission of community-acquired methicillin-resistant Staphylococcus aureus among postpartum women.  Clin Infect Dis. 2003;  37 1313-1319
    CrossrefPubMedSearch in Google Scholar
  • 3 Bratu S, Eramo A, Kopec R et al.. Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units.  Emerg Infect Dis. 2005;  11 808-813
    CrossrefPubMedSearch in Google Scholar
  • 4 Gastelum D T, Dassey D, Mascola L, Yasuda L M. Transmission of community-associated methicillin-resistant Staphylococcus aureus from breast milk in the neonatal intensive care unit.  Pediatr Infect Dis J. 2005;  24 1122-1124
    CrossrefPubMedSearch in Google Scholar
  • 5 Eckhardt C, Halvosa J S, Ray S M, Blumberg H M. Transmission of methicillin-resistant Staphylococcus aureus in the neonatal intensive care unit from a patient with community-acquired disease.  Infect Control Hosp Epidemiol. 2003;  24 460-461
    CrossrefPubMedSearch in Google Scholar
  • 6 Kluytmans-Vandenbergh M F, Kluytmans J A. Community-acquired methicillin-resistant Staphylococcus aureus: current perspectives.  Clin Microbiol Infect. 2006;  12(Suppl 1) 9-15
    PubMedSearch in Google Scholar
  • 7 Kollef M H, Micek S T. Methicillin-resistant Staphylococcus aureus: a new community-acquired pathogen?.  Curr Opin Infect Dis. 2006;  19 161-168
    PubMedSearch in Google Scholar
  • 8 Maltezou H C, Giamarellou H. Community-acquired methicillin-resistant Staphylococcus aureus infections.  Int J Antimicrob Agents. 2006;  27 87-96
    CrossrefPubMedSearch in Google Scholar
  • 9 Cool-Foley A A, Nathan C, O'Donovan III C, Simon D. Eradication of methicillin-resistant Staphylococcus aureus vaginitis with mupirocin.  DICP. 1991;  25 1331-1333
    CrossrefPubMedSearch in Google Scholar
  • 10 Mitsuda T, Arai K, Fujita S, Yokota S. Demonstration of mother-to-infant transmission of Staphylococcus aureus by pulsed-field gel electrophoresis.  Eur J Pediatr. 1996;  155 194-199
    CrossrefPubMedSearch in Google Scholar
  • 11 Chen K T, Campbell H, Borrell L N, Huard R C, Saiman L, Della-Latta P. Predictors and outcomes for pregnant women with vaginal-rectal carriage of community-associated methicillin-resistant Staphylococcus aureus .  Am J Perinatol. 2007;  24 235-240
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Rotas M, McCalla S, Liu C, Minkoff H. Methicillin-resistant Staphylococcus aureus necrotizing pneumonia arising from an infected episiotomy site.  Obstet Gynecol. 2007;  109(2 Pt2) 533-536
    CrossrefPubMedSearch in Google Scholar
  • 13 Perl T M, Golub J E. New approaches to reduce Staphylococcus aureus nosocomial infection rates: treating S. aureus nasal carriage.  Ann Pharmacother. 1998;  32 S7-S16
    CrossrefPubMedSearch in Google Scholar
  • 14 Wenzel R P, Perl T M. The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection.  J Hosp Infect. 1995;  31 13-24
    CrossrefPubMedSearch in Google Scholar
  • 15 Perl T M, Cullen J J, Wenzel R P et al.. Mupirocin and the risk of Staphylococcus aureus study team: intranasal mupirocin to prevent postoperative Staphylococcus aureus infections.  N Engl J Med. 2002;  346 1871-1877
    CrossrefPubMedSearch in Google Scholar

Paul G StumpfM.D. F.A.C.O.G. 

Professor and Chair of Obstetrics and Gynecology, University of Nevada School of Medicine

2040 W. Charleston Blvd., Suite 200, Las Vegas, NV 89102