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Fatal case due to methicillin-resistant Staphylococcus aureus small colony variants in an AIDS patient
H Seifert1, C von Eiff, G Fätkenheuer
1University of Cologne, Germany. harald.seifert@uni-koeln.de
Abstract:
We describe the first known case of a fatal infection with small colony variants of methicillin-resistant Staphylococcus aureus in a patient with AIDS. Recovered from three blood cultures as well as from a deep hip abscess, these variants may have resulted from long-term antimicrobial therapy with trimethoprim/sulfamethoxazole for prophylaxis of Pneumocystis carinii pneumonia.
Insights
This case report details a fatal infection caused by small colony variants of methicillin-resistant Staphylococcus aureus (MRSA) in an AIDS patient. Long-term antibiotic use may have contributed to the emergence of these difficult-to-treat MRSA variants.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Small colony variants (SCVs) of Staphylococcus aureus are associated with persistent and recurrent infections.
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant global health threat, particularly in immunocompromised individuals.
- Patients with Acquired Immunodeficiency Syndrome (AIDS) are susceptible to opportunistic infections due to impaired immune function.
Observation:
- A patient with AIDS presented with a deep hip abscess and sepsis.
- Blood cultures and abscess aspirates yielded small colony variants of methicillin-resistant Staphylococcus aureus (MRSA).
- The patient had a history of long-term antimicrobial prophylaxis with trimethoprim/sulfamethoxazole.
Findings:
- This represents the first documented fatal infection attributed to MRSA SCVs in a patient with AIDS.
- The isolation of MRSA SCVs from multiple sites suggests a disseminated infection.
- The prolonged antibiotic therapy might have selected for or promoted the development of these SCVs.
Implications:
- This case highlights the potential for antimicrobial resistance and the emergence of challenging MRSA phenotypes in immunocompromised patients.
- Understanding the role of SCVs in persistent infections is crucial for developing effective treatment strategies.
- Further research is needed to elucidate the mechanisms by which SCVs develop and their clinical significance in patients with underlying immune deficiencies.