Work

Environmental stabilization for recurrent Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus infection in an infant with autoimmune neutropenia: A case report applying Bronfenbrenner’s ecological model

Year: 2026

Type: article

Abstract: (MRSA) infection control is a formidable challenge in family practice. In vulnerable patients, such as those with autoimmune neutropenia (AIN), the risk of chronic recurrence is exceptionally high. We present a 10-month-old infant with AIN who suffered recurrent skin and soft tissue infections caused by PVL-positive MRSA. Given the limited efficacy of standard antimicrobial therapy in this immunocompromised host, we shifted our strategy from conventional decolonization to systematic environmental stabilization, addressing the colonization pressure inherent in community-acquired MRSA. Guided by Bronfenbrenner's ecological model, we conceptualized infection control through nested environmental levels: the microsystem (biological synergy between AIN and PVL), mesosystem (household hygiene), exosystem (parental workplaces), and macrosystem (global endemicity). Given the rise in antimicrobial resistance and the shift toward stringent stewardship, integrating an ecological model is essential in the era of hypervirulent PVL-positive MRSA.

Source: Journal of Family Medicine and Primary Care

DOI: 10.4103/jfmpc.jfmpc_686_26

Authors: Kenichiro Kobayashi, Takumi Sato, Aiko Aoyama, Ikuya Usami, Shigeru Fujimura, Yusei Ohshima

Institutions: Hyogo Prefectural Amagasaki General Medical Center, Tohoku Medical and Pharmaceutical University

Language: English

Topic: Antimicrobial Resistance in Staphylococcus

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $450