Acquired subglottic stenosis caused by methicillin resistant Staphylococcus aureus that produce epidermal cell differentiation inhibitor

Arch Dis Child Fetal Neonatal Ed. 2001 Jan;84(1):F38-9. doi: 10.1136/fn.84.1.f38.


Local infection of the trachea in intubated neonates is one of the main risk factors for development of acquired subglottic stenosis, although its role in the pathogenesis is unclear. Methicillin resistant Staphylococcus aureus (MRSA) is often the cause of critical illness in neonatal patients. Two cases are reported of acquired subglottic stenosis following bacterial infection of the trachea, suggesting an association with the staphylococcal exotoxin, epidermal cell differentiation inhibitor (EDIN). EDIN-producing MRSA were isolated from purulent tracheal secretions from both infants. Acquired subglottic stenosis in both cases was probably caused by delayed wound healing as the result of EDIN inhibition of epithelial cell migration.

Publication types

  • Case Reports

MeSH terms

  • Epidermal Growth Factor / antagonists & inhibitors*
  • Epidermal Growth Factor / biosynthesis
  • Female
  • Humans
  • Infant, Newborn
  • Intubation, Intratracheal / adverse effects
  • Laryngostenosis / microbiology*
  • Laryngostenosis / surgery
  • Methicillin Resistance
  • Shock, Septic / etiology
  • Shock, Septic / surgery
  • Staphylococcal Infections / complications*
  • Staphylococcal Infections / surgery
  • Staphylococcus aureus / physiology*
  • Tracheotomy


  • Epidermal Growth Factor