Objective To describe a case of generalised bullous impetigo caused by methicillin-resistant Staphylococcus aureus (MRSA) in new born.
Observation A masculin infant was born at full term pregnancy to a healthy mother by cesarian section because of rupture of membranes and acute fetal distress. He was normal within 48 h of life and C reactive protein (CRP) was negative, so he was discharged from the hospital. He presented at the age of 3 days erythematous pultaceous lesions of the face without fever. He was hospitalised at the age of 5 days. On examination, we noted on his face, neck and back multiple shallow erosions and flaccid pus-filled bullae, varying in size.
Investigations including complete hemogram, renal function tests and CRP had results within normal limits. A smear from a pustular lesion and blood culture were done. The infant was started on intravenous oxacillin (100 mg/kg/day) and gentamicin (5 mg/kg/day). The culture of the two samples was positive for MRSA which was resistant to kanamycin and fusidic acid. Antibiotic therapy was modified by vancomycin and pristinamycin for total treatment duration of 14 days. The outcome was favourable with rapid regression of skin lesion. Search by PCR of the mecA gene and the gene encoding Panton-Valentine Leukocidine was positive for the 2 strains of MRSA isolated from blood culture and pustule.
Conclusion Community-acquired, methicillin-resistant Staphylococcus aureus infections are increasing among children. Early diagnosis and appropriate antimicrobial therapy improve outcomes.