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Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report

INTRODUCTION: Staphylococcus epidermidis is currently the most frequent pathogen of opportunistic and nosocomial infections worldwide. Most cases of Staphylococcus epidermidis infections are associated with indwelling medical devices and/or immunocompromised conditions. Community-acquired urinary tr...

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Autores principales: Kanai, Hiroaki, Sato, Hiroki, Takei, Yoshichika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308012/
https://www.ncbi.nlm.nih.gov/pubmed/25488491
http://dx.doi.org/10.1186/1752-1947-8-415
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author Kanai, Hiroaki
Sato, Hiroki
Takei, Yoshichika
author_facet Kanai, Hiroaki
Sato, Hiroki
Takei, Yoshichika
author_sort Kanai, Hiroaki
collection PubMed
description INTRODUCTION: Staphylococcus epidermidis is currently the most frequent pathogen of opportunistic and nosocomial infections worldwide. Most cases of Staphylococcus epidermidis infections are associated with indwelling medical devices and/or immunocompromised conditions. Community-acquired urinary tract infections are rare, particularly among pediatric populations, and clinicians often do not consider Staphylococcus epidermidis as a uropathogen. CASE PRESENTATION: A previously healthy Japanese boy developed pyelonephritis caused by Enterococcus faecalis at 10 months of age. Subsequently, he was diagnosed with severe bilateral vesicoureteral reflux (right side grade V, left side grade III), and was administered trimethoprim/sulfamethoxazole as the prophylaxis. At 18 months of age, he presented with fever. Gram staining of urine obtained through catheterization revealed gram-positive cocci. We suspected pyelonephritis caused by enterococci, and administered oral fluoroquinolone empirically. The fever promptly resolved, and eventually, methicillin-resistant Staphylococcus epidermidis was detected at significant levels in the urine. Thus, our final diagnosis was pyelonephritis caused by community-acquired methicillin-resistant Staphylococcus epidermidis. CONCLUSIONS: Our case indicated that even immunocompetent children without a urinary catheter can develop Staphylococcus epidermidis pyelonephritis. Staphylococcus epidermidis can be underdiagnosed or misdiagnosed as sample contamination in community-acquired urinary tract infections. Therefore, when Gram staining of appropriately obtained urine samples reveals gram-positive cocci, clinicians should take into consideration not only the possibility of enterococci but also staphylococci, including Staphylococcus epidermidis, particularly in children with urinary abnormalities and/or those receiving continuous antibiotic prophylaxis.
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spelling pubmed-43080122015-01-28 Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report Kanai, Hiroaki Sato, Hiroki Takei, Yoshichika J Med Case Rep Case Report INTRODUCTION: Staphylococcus epidermidis is currently the most frequent pathogen of opportunistic and nosocomial infections worldwide. Most cases of Staphylococcus epidermidis infections are associated with indwelling medical devices and/or immunocompromised conditions. Community-acquired urinary tract infections are rare, particularly among pediatric populations, and clinicians often do not consider Staphylococcus epidermidis as a uropathogen. CASE PRESENTATION: A previously healthy Japanese boy developed pyelonephritis caused by Enterococcus faecalis at 10 months of age. Subsequently, he was diagnosed with severe bilateral vesicoureteral reflux (right side grade V, left side grade III), and was administered trimethoprim/sulfamethoxazole as the prophylaxis. At 18 months of age, he presented with fever. Gram staining of urine obtained through catheterization revealed gram-positive cocci. We suspected pyelonephritis caused by enterococci, and administered oral fluoroquinolone empirically. The fever promptly resolved, and eventually, methicillin-resistant Staphylococcus epidermidis was detected at significant levels in the urine. Thus, our final diagnosis was pyelonephritis caused by community-acquired methicillin-resistant Staphylococcus epidermidis. CONCLUSIONS: Our case indicated that even immunocompetent children without a urinary catheter can develop Staphylococcus epidermidis pyelonephritis. Staphylococcus epidermidis can be underdiagnosed or misdiagnosed as sample contamination in community-acquired urinary tract infections. Therefore, when Gram staining of appropriately obtained urine samples reveals gram-positive cocci, clinicians should take into consideration not only the possibility of enterococci but also staphylococci, including Staphylococcus epidermidis, particularly in children with urinary abnormalities and/or those receiving continuous antibiotic prophylaxis. BioMed Central 2014-12-09 /pmc/articles/PMC4308012/ /pubmed/25488491 http://dx.doi.org/10.1186/1752-1947-8-415 Text en © Kanai et al.; licensee BioMed Central. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kanai, Hiroaki
Sato, Hiroki
Takei, Yoshichika
Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title_full Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title_fullStr Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title_full_unstemmed Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title_short Community-acquired methicillin-resistant Staphylococcus epidermidis pyelonephritis in a child: a case report
title_sort community-acquired methicillin-resistant staphylococcus epidermidis pyelonephritis in a child: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4308012/
https://www.ncbi.nlm.nih.gov/pubmed/25488491
http://dx.doi.org/10.1186/1752-1947-8-415
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