Acquired subglottic stenosis caused by methicillin resistant Staphylococcus aureus that produce epidermal cell differentiation inhibitor
Y Yamadaa, M Sugaib, M Wooa, N Nishidaa, T Sugimotoa
a Department of
Pediatrics, Kansai Medical University Otokoyama Hospital, Kyoto, Japan, b Department of Microbiology, Hiroshima
University, School of Dentistry, Hiroshima, Japan
Correspondence to: Dr Sugimoto, Department of Pediatrics, Kansai Medical University Otokoyama Hospital, Izumi 19, Otokoyama, Yawata, Kyoto 614-8366, Japan ken-sugi{at}gb3.so-net.ne.jp
Accepted 8 September
2000
Local infection of the trachea in intubated neonates is one of
the main risk factors for development of acquired subglottic stenosis,
although its role in the pathogenesis is unclear. Methicillin resistant
Staphylococcus aureus (MRSA) is often the
cause of critical illness in neonatal patients. Two cases are reported
of acquired subglottic stenosis following bacterial infection of the
trachea, suggesting an association with the staphylococcal exotoxin,
epidermal cell differentiation inhibitor (EDIN). EDIN-producing MRSA
were isolated from purulent tracheal secretions from both infants. Acquired subglottic stenosis in both cases was probably caused by
delayed wound healing as the result of EDIN inhibition of epithelial cell migration.
Keywords: acquired subglottic stenosis; epidermal cell differentiation inhibitor; methicillin resistant Staphylococcus aureus; neonates; neonatal toxic shock syndrome-like exanthematous disease
© 2001 by Archives of Disease in Childhood
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