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Peer-reviewedCC BY-NC-NDJournal of family medicine and primary care

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

  • Kenichiro Kobayashi1
  • Takumi Sato2
  • Aiko Aoyama3
  • Ikuya Usami1
  • Shigeru Fujimura2
  • Yusei Ohshima4
4 affiliations
  1. 1Department of Pediatrics, Pediatric Hematology and Oncology Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
  2. 2Division of Clinical Infectious Diseases and Chemotherapy, Graduate School of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
  3. 3Uniconomori Baby and Kid’s Clinic, Hyogo, Japan
  4. 4Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan
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Abstract

Managing Panton–Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (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.

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Cite

BibTeXRIS
BibTeX
@article{kobayashi2026environmental,
  title = {{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}},
  author = {Kenichiro Kobayashi and Takumi Sato and Aiko Aoyama and Ikuya Usami and Shigeru Fujimura and Yusei Ohshima},
  journal = {Journal of family medicine and primary care},
  year = {2026},
  month = jul,
  doi = {10.4103/jfmpc.jfmpc_686_26},
  url = {https://europepmc.org/article/PMC/PMC13722259},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - 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
AU  - Kenichiro Kobayashi
AU  - Takumi Sato
AU  - Aiko Aoyama
AU  - Ikuya Usami
AU  - Shigeru Fujimura
AU  - Yusei Ohshima
PY  - 2026
DA  - 2026/07/01
JO  - Journal of family medicine and primary care
DO  - 10.4103/jfmpc.jfmpc_686_26
UR  - https://europepmc.org/article/PMC/PMC13722259
AB  - Managing Panton–Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (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.
SN  - 2249-4863
SN  - 2278-7135
ER  -