家族内伝播したMRSAによるブドウ球菌性熱傷様皮膚症候群

・メチシリン耐性黄色ブドウ球菌（Methicillin-resistant Staphylococcus aureus：MRSA）によるブドウ球菌性熱傷様皮膚症候群（staphylococcal scalded skin syndrome：SSSS）で入院した姉から母親と弟へ家族内伝播したと考えられる親子3人のMRSA感染症を経験した．

・MRSA感染症は院内獲得型で，日和見感染として認識されてきたが，近年，市中獲得型が増加し問題となっている．

・MRSA感染症ではセフェム系等の抗菌薬で皮膚症状が軽快したのちも，鼻腔内保菌による伝播がおこりうることに注意が必要である．

（「症例のポイント」より）

　

Staphylococcal scalded skin syndrome due to MRSA spread in the family

　

Kubo, Naoko1）Ogawa, Tetsushi2）Ito, Junko2）Hayashi, Nobukazu1） 1）Department of Dermatology, Toranomon Hospital 2）Department of Pediatrics, Toranomon Hospital

　

A two-year-old girl complained of fever, erythema, and ocular mucous and was hospitalized due to staphylococcal scalded skin syndrome caused by methicillin-resistant Staphylococcus aureus (MRSA). Her symptoms disappeared after treatment with cefazolin. One month after discharge, her 4-month-old younger brother and their mother were hospitalized with similar symptoms. MRSA was detected in both their nasal cavities. The mother had been nursing during her son’s hospitalization. Therefore, we supposed that the mother became a carrier of MRSA, which was contracted from her daughter；then, MRSA spread from her nasal cavity to her son’s skin at home. Our case findings indicate that MRSA should be completely treated to prevent familial spread.