{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:36:45Z","timestamp":1770287805122,"version":"3.49.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Community-acquired Methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (CA-MRSA) is an emerging pathogen that leads to severe outcomes, especially in pediatric patients with multiple sites infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a case of multiple sites and life-threatening infection caused by CA-MRSA in a 6-year-old girl who manifested sepsis, myelitis, purulent arthritis, purulent meningitis, hydropericardium, pneumonia, and empyema. The girl exhibited good response to the combination therapy of linezolid and rifampicin after treatment failure of vancomycin with maximum dose due to its serum concentration unable to reach therapeutic goal. We performed pleural effusion and hydropericardium effusion drainage and treated left lower limb infection using interdisciplinary approaches.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This case highlights the need to be aware of CA-MRSA infection, which requires accurate diagnosis, identification of infected sites, appropriate antibiotic treatment, and surgical debridement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07148-1","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T13:05:54Z","timestamp":1646312754000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multi-site infection by methicillin-resistant Staphylococcus aureus in a six-year old girl: a case report"],"prefix":"10.1186","volume":"22","author":[{"given":"Pei","family":"Xiao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixue","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanqing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quanli","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2369-1663","authenticated-orcid":false,"given":"Gangfeng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,3,3]]},"reference":[{"issue":"8","key":"7148_CR1","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1056\/NEJM199808203390806","volume":"339","author":"FD Lowy","year":"1998","unstructured":"Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998;339(8):520\u201332.","journal-title":"N Engl J Med"},{"issue":"6","key":"7148_CR2","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.surge.2012.05.003","volume":"10","author":"H Humphreys","year":"2012","unstructured":"Humphreys H. Staphylococcus aureus: the enduring pathogen in surgery. Surgeon. 2012;10(6):357\u201360.","journal-title":"Surgeon"},{"issue":"6","key":"7148_CR3","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1016\/j.ijmm.2013.02.005","volume":"303","author":"JA Lindsay","year":"2013","unstructured":"Lindsay JA. Hospital-associated MRSA and antibiotic resistance\u2014what have we learned from genomics? Int J Med Microbiol. 2013;303(6):318\u201323.","journal-title":"Int J Med Microbiol"},{"issue":"6\u20137","key":"7148_CR4","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.ijmm.2013.02.007","volume":"303","author":"M Otto","year":"2013","unstructured":"Otto M. Community-associated MRSA: what makes them special? Int J Med Microbiol. 2013;303(6\u20137):324\u201330.","journal-title":"Int J Med Microbiol"},{"issue":"4","key":"7148_CR5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.5365\/wpsar.2017.8.1.014","volume":"8","author":"Thomas S, Crooks K, Islam F, Massey PD","year":"2017","unstructured":"Thomas S, Crooks K, Islam F, Massey PD. Community-associated methicillin-resistant Staphylococcus aureus infections in Aboriginal children attending hospital emergency departments in a regional area of New South Wales, Australia: a seven-year descriptive study. West Pac Surveill Response J. 2017;8(4):6\u201312.","journal-title":"West Pac Surveill Response J"},{"issue":"8","key":"7148_CR6","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1007\/s10096-010-0973-4","volume":"29","author":"MC Wehrhahn","year":"2010","unstructured":"Wehrhahn MC, Robinson JO, Pearson JC, O\u2019Brien FG, Tan HL, Coombs GW, et al. Clinical and laboratory features of invasive community-onset methicillin-resistant Staphylococcus aureus infection: a prospective case\u2013control study. Eur J Clin Microbiol Infect Dis. 2010;29(8):1025\u201333.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"6","key":"7148_CR7","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1093\/cid\/ciu410","volume":"59","author":"MZ David","year":"2014","unstructured":"David MZ, Daum RS, Bayer AS, Chambers HF, Fowler VG Jr, Miller LG, et al. Staphylococcus aureus bacteremia at 5 US academic medical centers, 2008\u20132011: significant geographic variation in community-onset infections. Clin Infect Dis. 2014;59(6):798\u2013807.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"7148_CR8","first-page":"508","volume":"114","author":"G Perez","year":"2016","unstructured":"Perez G, Martiren S, Reijtman V, Romero R, Mastroianni A, Casimir L, et al. Community-acquired Staphylococcus aureus bacteremia in children: a cohort study for 2010\u20132014. Arch Argent Pediatr. 2016;114(6):508\u201313.","journal-title":"Arch Argent Pediatr"},{"key":"7148_CR9","doi-asserted-by":"publisher","first-page":"18033","DOI":"10.1038\/nrdp.2018.33","volume":"4","author":"AS Lee","year":"2018","unstructured":"Lee AS, de Lencastre H, Garau J, Kluytmans J, Malhotra-Kumar S, Peschel A, et al. Methicillin-resistant Staphylococcus aureus. Nat Rev Dis Primers. 2018;4:18033.","journal-title":"Nat Rev Dis Primers"},{"issue":"4","key":"7148_CR10","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/s41579-018-0147-4","volume":"17","author":"NA Turner","year":"2019","unstructured":"Turner NA, Sharma-Kuinkel BK, Maskarinec SA, Eichenberger EM, Shah PP, Carugati M, et al. Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research. Nat Rev Microbiol. 2019;17(4):203\u201318.","journal-title":"Nat Rev Microbiol"},{"key":"7148_CR11","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.GPP3-0057-2018","author":"M Vestergaard","year":"2019","unstructured":"Vestergaard M, Frees D, Ingmer H. Antibiotic resistance and the MRSA problem. Microbiol Spectr. 2019. https:\/\/doi.org\/10.1128\/microbiolspec.GPP3-0057-2018.","journal-title":"Microbiol Spectr"},{"issue":"1","key":"7148_CR12","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jhin.2010.11.023","volume":"78","author":"You JHS, Mak MMW, To LYT, Ip M","year":"2011","unstructured":"You JHS, Mak MMW, To LYT, Ip M. Complicated infections with meticillin-resistant Staphylococcus aureus in Hong Kong. J Hosp Infect. 2011;78(1):71\u20132.","journal-title":"J Hosp Infect"},{"issue":"3","key":"7148_CR13","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1093\/cid\/ciq146","volume":"52","author":"C Liu","year":"2011","unstructured":"Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clin Infect Dis. 2011;52(3):e18-55.","journal-title":"Clin Infect Dis"},{"key":"7148_CR14","doi-asserted-by":"crossref","unstructured":"Wang X, Shen Y, Huang W, Zhou Y. Characterisation of community-acquired Staphylococcus aureus causing skin and soft tissue infections in a children's hospital in Shanghai, China. Epidemiol Infect. 2019;147:e323.","DOI":"10.1017\/S0950268819002127"},{"key":"7148_CR15","doi-asserted-by":"publisher","first-page":"332","DOI":"10.3389\/fmicb.2018.00332","volume":"9","author":"S Li","year":"2018","unstructured":"Li S, Sun S, Yang C, Chen H, Yin Y, Li H, et al. The changing pattern of population structure of Staphylococcus aureus from bacteremia in China from 2013 to 2016: ST239-030-MRSA replaced by ST59-t437. Front Microbiol. 2018;9:332.","journal-title":"Front Microbiol"},{"key":"7148_CR16","doi-asserted-by":"publisher","first-page":"1211","DOI":"10.3389\/fmicb.2018.01211","volume":"9","author":"X Wang","year":"2018","unstructured":"Wang X, Liu Q, Zhang H, Li X, Huang W, Fu Q, et al. Molecular characteristics of community-associated Staphylococcus aureus isolates from pediatric patients with bloodstream infections between 2012 and 2017 in Shanghai, China. Front Microbiol. 2018;9:1211.","journal-title":"Front Microbiol"},{"key":"7148_CR17","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1186\/s12879-016-1630-z","volume":"16","author":"Changchien C-H, Chen S-W, Chen Y-Y, Chu C","year":"2016","unstructured":"Changchien C-H, Chen S-W, Chen Y-Y, Chu C. Antibiotic susceptibility and genomic variations in Staphylococcus aureus associated with Skin and Soft Tissue Infection (SSTI) disease groups. BMC Infect Dis. 2016;16:276\u2013276.","journal-title":"BMC Infect Dis"},{"issue":"11","key":"7148_CR18","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1093\/ajhp\/zxaa036","volume":"77","author":"MJ Rybak","year":"2020","unstructured":"Rybak MJ, Le J, Lodise TP, Levine DP, Bradley JS, Liu C, et al. Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: a revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Am J Health Syst Pharm. 2020;77(11):835\u201364.","journal-title":"Am J Health Syst Pharm"},{"issue":"2","key":"7148_CR19","doi-asserted-by":"crossref","first-page":"230949901985032","DOI":"10.1177\/2309499019850324","volume":"27","author":"Haseeb A, Ajit Singh V, Teh CSJ, Loke MF","year":"2019","unstructured":"Haseeb A, Ajit Singh V, Teh CSJ, Loke MF. Addition of ceftaroline fosamil or vancomycin to PMMA: an in vitro comparison of biomechanical properties and anti-MRSA efficacy. J Orthop Surg (Hong Kong). 2019;27(2):2309499019850324.","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"7","key":"7148_CR20","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1016\/j.cmi.2015.04.003","volume":"21","author":"Steinmetz T, Eliakim-Raz N, Goldberg E, Leibovici L, Yahav D","year":"2015","unstructured":"Steinmetz T, Eliakim-Raz N, Goldberg E, Leibovici L, Yahav D. Association of vancomycin serum concentrations with efficacy in patients with MRSA infections: a systematic review and meta-analysis. Clin Microbiol Infect. 2015;21(7):665\u201373.","journal-title":"Clin Microbiol Infect"},{"issue":"4","key":"7148_CR21","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1016\/j.ijantimicag.2014.12.017","volume":"45","author":"A Huttner","year":"2015","unstructured":"Huttner A, Von Dach E, Renzoni A, Huttner BD, Affaticati M, Pagani L, et al. Augmented renal clearance, low beta-lactam concentrations and clinical outcomes in the critically ill: an observational prospective cohort study. Int J Antimicrob Agents. 2015;45(4):385\u201392.","journal-title":"Int J Antimicrob Agents"},{"issue":"12","key":"7148_CR22","doi-asserted-by":"publisher","first-page":"2802","DOI":"10.1080\/13880209.2016.1183684","volume":"54","author":"Y Chu","year":"2016","unstructured":"Chu Y, Luo Y, Qu L, Zhao C, Jiang M. Application of vancomycin in patients with varying renal function, especially those with augmented renal clearance. Pharm Biol. 2016;54(12):2802\u20136.","journal-title":"Pharm Biol"},{"issue":"1","key":"7148_CR23","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s13756-020-00714-9","volume":"9","author":"A Shariati","year":"2020","unstructured":"Shariati A, Dadashi M, Chegini Z, van Belkum A, Mirzaii M, Khoramrooz SS, et al. The global prevalence of Daptomycin, Tigecycline, Quinupristin\/Dalfopristin, and Linezolid-resistant Staphylococcus aureus and coagulase\u2013negative staphylococci strains: a systematic review and meta-analysis. Antimicrob Resist Infect Control. 2020;9(1):56.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"6","key":"7148_CR24","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1097\/INF.0000000000001121","volume":"35","author":"S Garazzino","year":"2016","unstructured":"Garazzino S, Castagnola E, Di Gangi M, Ortolano R, Krzysztofiak A, Nocerino A, et al. Daptomycin for children in clinical practice experience. Pediatr Infect Dis J. 2016;35(6):639\u201341.","journal-title":"Pediatr Infect Dis J"},{"issue":"6","key":"7148_CR25","doi-asserted-by":"publisher","first-page":"e02462","DOI":"10.1128\/AAC.02462-17","volume":"62","author":"C Antachopoulos","year":"2018","unstructured":"Antachopoulos C, Ilia S, Kadiltzoglou P, Baira E, Dokoumetzidis A, Gikas E, et al. Pharmacokinetics of daptomycin in critically ill pediatric patients. Antimicrob Agents Chemother. 2018;62(6):e02462-e2517.","journal-title":"Antimicrob Agents Chemother"},{"issue":"5","key":"7148_CR26","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1097\/INF.0b013e3182864e4c","volume":"32","author":"F Gesualdo","year":"2013","unstructured":"Gesualdo F, Bongiorno D, Rizzo C, Bella A, Menichella D, Stefani S, et al. MRSA nasal colonization in children: prevalence meta-analysis, review of risk factors and molecular genetics. Pediatr Infect Dis J. 2013;32(5):479\u201385.","journal-title":"Pediatr Infect Dis J"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07148-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-022-07148-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-022-07148-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T13:06:22Z","timestamp":1646312782000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-022-07148-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,3]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["7148"],"URL":"https:\/\/doi.org\/10.1186\/s12879-022-07148-1","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,3]]},"assertion":[{"value":"13 March 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"As this publication concerns single patient data in the form of a case report, ethics approval by the institutional review board was not required. Consent to participate has been obtained from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of their clinical details and clinical images was obtained from the parent of the patient. A copy of the consent form is available for review by the Editor of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"210"}}