Severe community-acquired infection caused by methicillin-resistant Staphylococcus aureus in Saudi Arabian children

Community acquired methicillin-resistantStaphylococcus aureus (CA-MRSA) infection hasbecome a major pathogen causing significant infectionin children in Saudi Arabia. It has emerged as afrequent cause of skin and soft tissue infections andcan be associated with life-threatening complication ssuch as necrotizing pneumonia and sepsis. BetweenJanuary 2005 and March 2008, 5 (6%) previouslyhealthy children with invasive CA-MRSA infectionswere identified from 80 children with communityonsetMRSA infections. Three children hadosteomyelitis, with one patient presenting a fulminantand extensive soft tissue and bone destructioncomplicated by deep vein thrombosis and pathologicalfracture. One child had deep-seated infection, andone infant had severe orbital cellulitis and bilateralorbital abscess complicated by subdural empyema.The median age was 4-years (range 3 months to 17years). Onl y one patient had a risk factor.Two patientswere initially treated with ineffective ant imicrobialtherapy (bera-lactam). On e isolate showed inducibl eclindamycin resistance. The recovery was uneventfulin all patients. This report should increase theawareness of clinicians regarding severe CA-MRSAinfections and highlight the challenges encounteredin the choice of therapy of serious infections causedby this organism.