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

Abstract

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.

Keywords: Community-acquired MRSA; Infective endocarditis; ST 630; Surgical therapy.

Fig. 1

Infective endocarditis complicating systemic embolism (the arrows indicate areas of interest) and detection of key genes. (A) Color Doppler echocardiography showing the vegetation attached to the anterior mitral valve leaflet. (B) Spiral computed tomography showing renal infarction. (C) Echocardiographic examination showing embolization of the right common iliac artery and right internal and external iliac arteries. (D) Computed tomography of the brain showing multiple low-density lesions. (E). Detection of antimicrobial genes, virulence-related genes and adhesion genes by PCR amplification. Lane 1, molecular weight marker; lane 2, mecA; lane 3, ermC; lane 4, blaZ; lane 5, clfA; lane 6, clfB; lane 7, icaA; lane 8, efb; lane 9, fnbA; lane 10, hlb; lane 11, hld; lane 12, hlg2.