%0 Case Reports
%T Relapsing bronchopneumonia due to community-associated methicillin-resistant Staphylococcus aureus: a case report.
%A Shimada S
%A Yamaguchi T
%A Mikoshiba S
%A Sato K
%A Mitsumura T
%A Komori K
%A Yamana T
%A Iijima Y
%A Sakakibara R
%A Shibata S
%A Honda T
%A Shirai T
%A Okamoto T
%A Furusawa H
%A Tateishi T
%A Miyazaki Y
%J BMC Infect Dis
%V 24
%N 1
%D 2024 Apr 4
%M 38575909
%F 3.667
%R 10.1186/s12879-024-09268-2
%X <B>BACKGROUND: </B>The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased the incidence of community-onset MRSA infection. Respiratory tract infections caused by MRSA has been noted for their severity; however, repeated relapses that require extended antibiotic therapy are rare.<BR><B>METHODS: </B>We report a case of relapsing bronchopneumonia caused by CA-MRSA in a 56-year-old man. The patient responded to antibiotics, but repeatedly relapsed after stopping treatment. MRSA was consistently isolated from airway specimens during each relapse. Extended oral antibiotic treatment with trimethoprim/sulfamethoxazole (TMP/SMX) for 6 months achieved infection control. Whole-genome sequencing of the isolated strain revealed that the causative agent was sequence type (ST)1/staphylococcal cassette chromosome mec (SCCmec) type IVa, a clone that is rapidly increasing in Japan.<BR><B>CONCLUSIONS: </B>This patient had an unusual course of MRSA bronchopneumonia with repeated relapses. Although the choice of antibiotics for long-term use in MRSA respiratory tract infections has not been well established, TMP/SMX was effective and well tolerated for long-term therapy in this case. The clinical course of infections related to the rapid emerging clone, ST1/SCCmec type IVa warrants further attention.