Journal of Clinical Pediatrics ›› 2024, Vol. 42 ›› Issue (8): 728-736.doi: 10.12372/jcp.2024.23e1225

• Pediatric Grand Rounds • Previous Articles     Next Articles

Treatment and reflection of infective endocarditis caused by methicillin-resistant Staphylococcus aureus in children after complex congenital heart disease

HUANG Shiyu1, WANG Wei1, ZHU Diqi2, SHEN Jie2, CAO Qing1()   

  1. 1. Department of Infectious Disease, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
    2. Department of Cardiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
  • Received:2023-12-26 Online:2024-08-15 Published:2024-08-06

Abstract:

The patient, male, 6 years and 10 months old, was admitted to our hospital because of “repeated fever for 2 months and mental fatigue for half a day”. The patient had congenital heart disease in the past, and fever occurred after modified body to pulmonary circulation shunt. Multiple blood cultures indicated methicillin-resistant Staphylococcus aureus (MRSA), and echocardiography indicated that the tube was not smooth. The patient was diagnosed with infective endocarditis, and vancomycin, linezolid, meropenem and other anti-infective drugs were given. After the use of drugs, bone marrow suppression is obvious, infection control is poor. Emergency surgery was performed to remove the redundant organisms and recurrent fever after central shunt surgery. The patient’s condition improved and the infection was stably controlled, after switched to contizolamide anti-infective treatment with contezolid. Follow-up six months, the child has no recurrent infections, there is no organ damage and bone marrow suppression phenomenon, the echocardiogram showed that the blood flow is smooth. This case is intended to provide clinical ideas for clinicians to deal with this kind of complex infection, and to discuss the choice of drugs for anti-infection treatment of drug-resistant bacteria in children.

Key words: infective endocarditis, methicillin-resistant Staphylococcus aureus, antibiotic, contezolid, child