Serious Postpartum Infection Due to MRSA in an Asymptomatic Carrier: Case Report and Review

Abstract

Infection with methicillin-resistant Staphylococcus aureus (MRSA) has become a worldwide problem and is no longer acquired only in a hospital setting. Community-associated MRSA is an emerging pathogen of increasing interest to both obstetricians and neonatologists, reported in all three trimesters of pregnancy and postpartum, and in neonatal intensive care units, leading to severe outcomes, including neonatal death. This case report describes a serious and potentially life-threatening infection (including wound abscess, septicemia, septic thrombophlebitis, and septic pulmonary emboli) that developed in an otherwise healthy postpartum woman who had screened positive for MRSA in nares, vagina, and rectum at the time of her prior admission in labor as part of a research study. We conclude that asymptomatic nasal, vaginal, and rectal colonization with MRSA occurs in pregnancy and may be a risk factor for serious systemic infection after delivery.

Enhanced surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in children in the UK and Ireland

“…However, it was also notable that 8% of children were aged ≤2 days at the onset of MRSA bacteraemia, raising the possibility of mother to baby transmission. Although maternal MRSA colonisation was not investigated in this study, peripartum maternal colonisation (including vaginal colonisation), while rare, has nonetheless been reported 13 14…”

Methicillin-Resistant Staphylococcus aureus Bacteremia and Chorioamnionitis After Recurrent Marsupialization of a Bartholin Abscess

“…4,5 To our knowledge, only two previous reports have described chorioamnionitis due to MRSA. 6,7 Interestingly, both previous reports involved patients who were hospital staff.…”

Staphylococcus Infections in Pregnancy

“…57 Perineal abscess from infected episiotomy sites has been implicated in case reports. 58,59 Thurman and Lareau have also documented MRSA as the most common cause in a series of vulvar abscesses among gynecologic patients, providing further evidence of risk in perineal infection. 23,24 Mastitis and breast abscess Approximately 20% of women experience mastitis postpartum.…”