Postoperative infection of an abdominal mesh due to methicillin resistant Staphylococcus aureus - a case report

Area of Science:

• Infectious Diseases
• Surgical Site Infections
• Medical Microbiology

Background:

• Hospital-acquired infections, particularly Methicillin-resistant Staphylococcus aureus (MRSA), pose significant clinical challenges.
• Abdominal mesh, used for wall reinforcement, can be a nidus for persistent postoperative infections.
• Delayed diagnosis and treatment of MRSA can lead to complications like wound dehiscence.

Purpose of the Study:

• To report a case of MRSA infection originating from an abdominal mesh.
• To highlight the diagnostic and therapeutic approach for a challenging postoperative MRSA infection.
• To emphasize the importance of identifying the source of infection for effective management.

Main Methods:

• A patient with a history of abdominal wall reinforcement surgery presented with wound complications.
• Cultures from the wound, mesh, and nares/throat/axilla identified MRSA.
• Initial treatment with clindamycin was followed by vancomycin upon recurrence.

Main Results:

• MRSA was isolated from the surgical mesh, indicating it as the primary infection source.
• The patient experienced a recurrence of infection after initial treatment.
• Treatment with vancomycin resulted in MRSA clearance and complete wound healing.

Conclusions:

• Abdominal mesh can serve as a reservoir for MRSA, leading to late-onset surgical site infections.
• Prompt identification of the infection source and appropriate antibiotic selection, such as vancomycin, are crucial for successful MRSA eradication.
• This case underscores the importance of considering implanted devices in the etiology of persistent or recurrent postoperative infections.