MRSA Spinal Epidural Abscess as a Neurosurgical and Infectious Disease Emergency with Unresolved Antimicrobial Solution.

摘要: Spinal epidural abscess caused by MRSA, a life-threatening organism resistant to methicillin and other antibiotics, is rare but important infectious pathology due its potential damage the spinal cord. We present case of 74-year-old man who hematogenously seeded his entire canal from C1 sacrum with MRSA bacteria remained infected even after maximal treatment vancomycin daptomycin. Ceftaroline, new 5th generation antibiotic recently described clearance widespread infection in complex spine infections, was added as dual therapy for infection. A diabetic prior right total knee arthroplasty presented persistent bacteremia sepsis. He transferred our academic center diagnosis abscesses sacral levels midthoracic MRI T2 hyperintensities vertebral bodies disc concerning osteomyelitis discitis. Despite surgery IV MIC 1, suggesting extreme susceptibility, patient’s blood cultures persistently bacteremic at day 5 treatment. After 48 hours ceftaroline, came back showing no growth. The outcome unfavorable advanced nature multiple comorbidities, negative addition ceftaroline regime require further investigation into this therapy. Randomized controlled trials or combinatorial antibiotics should be considered disease.