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Central nervous system infection caused by vancomycin-intermediate Staphylococcus aureus (SCCmec type IV, ST8)

Hiroyoshi Kino1, Hiromichi Suzuki2, Tetsuo Yamaguchi3

  • 1Department of Neurosurgery, Tsukuba Medical Center Hospital, Ibaraki, Japan.

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|July 12, 2014
PubMed

Insights

This study reports the first case in Japan of brain and subdural abscesses caused by vancomycin-intermediate Staphylococcus aureus (VISA). The patient successfully recovered after treatment with linezolid.

Area of Science:

  • Infectious Diseases
  • Neurosurgery
  • Clinical Microbiology

Background:

  • Subdural and brain abscesses are serious intracranial infections requiring prompt diagnosis and treatment.
  • Staphylococcus aureus is a common pathogen, and the emergence of vancomycin-intermediate strains (VISA) poses a significant therapeutic challenge.
  • Surgical intervention is often necessary for abscess drainage.

Observation:

  • A 77-year-old Japanese male presented with symptoms of subdural and brain abscesses.
  • Pus cultures from both abscesses yielded vancomycin-intermediate Staphylococcus aureus (VISA), confirmed by population analysis (MIC = 4 μg/mL).
  • The identified VISA strain belonged to SCCmec type IV and sequence type ST8.

Findings:

  • The VISA isolates demonstrated susceptibility to levofloxacin, clindamycin, minocycline, and linezolid.
  • Successful treatment was achieved using linezolid, leading to patient discharge on day 51.
  • This case represents the first documented instance of VISA causing both subdural and brain abscesses in Japan.

Implications:

  • Highlights the clinical significance of VISA in neurosurgical infections.
  • Emphasizes the importance of antimicrobial susceptibility testing for Staphylococcus aureus, especially in cases of treatment failure or unusual presentations.
  • Suggests linezolid as a viable treatment option for VISA-associated brain and subdural abscesses.
Keywords:
Brain abscessSubdural abscessVancomycin-intermediate Staphylococcus aureus

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