Severe infective endocarditis with systemic embolism due to community associated methicillin-resistant <i>Staphylococcus aureus</i>ST630

Zheng, Beiwen; Jiang, Saiping; Xu, Zemin; Xiao, Yonghong; Li, Lanjuan

doi:10.1016/j.bjid.2014.07.006

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Case Reports • Braz J Infect Dis 19 (1) • Jan-Feb 2015 • https://doi.org/10.1016/j.bjid.2014.07.006 copy

Severe infective endocarditis with systemic embolism due to community associated methicillin-resistant Staphylococcus aureusST630

Authorship SCIMAGO INSTITUTIONS RANKINGS

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasingly causing infective endocarditis over the past decade. Here we report a healthy man who developed a severe acute infective endocarditis with systemic embolism caused by CA- MRSA. The strain was recovered from repeated blood cultures and was characterized using molecular detection and genotyping. The S. aureus isolate was typed as ST630 SCCmecV with spa-type t4549, agrI/IV and was PVL-negative. This is the only case report, to our knowledge, of CA-MRSA infective endocarditis in China. This case highlights the emergence and geographical spread of life-threatening CA-MRSA infection within China.

Community-acquired MRSA Infective endocarditis; ST 630; Surgical therapy

Age/sex	Country/region	Symptoms	Valve	SCCmec type	Treatment^a	pvl^b	Sequence type^c	Outcome	Ref.
20 M	Taiwan	Septicembolism	Mitral	NA	Va Vegetation removal	NA	NA	Recovered	12
47 M	Italy	Sepsis	Mitral	NA	Va, Ami Valve replacement	NA	ST5	Recovered	13
22 M	USA	Bacteremia, septic embolism	Aortic	Type IV	Cfz, Lnz	Pos	NA	Recovered	14
37 M	USA	Abscesses	Mitral	Type IV	Va, Lnz Valvular surgery	Pos	NA	Recovered	15
44 M	USA	Septic embolism	Aortic	Type IV	Va Incision and drainage	Pos	NA	Recovered	15
27 M	Brazil	Headache, fever	Mitral	Type IV	Cro, Va	Pos	NA	Recovered	16
39 F	Korea	High fever, chill	Mitral	Type IV	Pen, Va and Gen Surgical intervention	Neg	ST72	Recovered	17
61 F	Italy	Fever, weakness, pain, dyspnea	Mitral and aortic	Type V	Va, Dap and Rif Pericardial puncture	Pos	ST 152	Recovered	18
79 F	Argentina	Bacteremia, brain abscesses	Aortic and mitral	Type IV	Va, Ts	Pos	ST5	Died	19
19 M	Australia	Brain abscesses, renal mycotic aneurysm and endophthalmitis	Aortic	NA	Va, Fa, Rif and Ct	Pos	ST 93	Recovered	20
2 M	Taiwan	Pneumonia	Tricuspid	Type V	Tei, Ts	Pos	ST 59	Recovered	9
49 M	China	Systemic embolism, bacteremia	Mitral	Type V	Lev, Fos, Va and Lnz Valve replacement	Neg	ST 630	Recovered	Current case

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[1] *Corresponding author at: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, The First Afﬁliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China. E-mail addresses: xiao-yonghong@163.com, ljli@zju.edu.cn (Y. Xiao).