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Acquired subglottic stenosis caused by methicillin resistantStaphylococcus aureus that produce epidermal cell differentiation inhibitor
  1. Y Yamadaa,
  2. M Sugaib,
  3. M Wooa,
  4. N Nishidaa,
  5. T Sugimotoa
  1. aDepartment of Pediatrics, Kansai Medical University Otokoyama Hospital, Kyoto, Japan, bDepartment of Microbiology, Hiroshima University, School of Dentistry, Hiroshima, Japan
  1. Dr Sugimoto, Department of Pediatrics, Kansai Medical University Otokoyama Hospital, Izumi 19, Otokoyama, Yawata, Kyoto 614-8366, Japanken-sugi{at}


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 resistantStaphylococcus 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.

  • acquired subglottic stenosis
  • epidermal cell differentiation inhibitor
  • methicillin resistantStaphylococcus aureus
  • neonates
  • neonatal toxic shock syndrome-like exanthematous disease

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