Download Acute necrotic somatitis “NOMA” associated with Methicillin

Acute necrotic somatitis “NOMA” associated with
Methicillin-resistant Staphylococcus aureus in a newly
acquired rhesus macaque (Macaca mulatta)
Jae-il Lee1, Kang-Seok Kim1, Nan-A Kim1, Byung-Cheol Oh1, Il-Hwan Kim4,
Chung-Gyu Park1,3*, Sang-Joon Kim1,2
1
Xenotransplantation Research Center, Seoul National University Hospital, Seoul, South Korea
Department of Surgery, Seoul National University Hospital, Seoul, South Korea
3
Department of Microbiology and Immunology, Seoul National University Hospital, Seoul, South Korea
4
Drug Evaluation Laboratory, Daewoong R&D Center, Samgye-Ri, Pogok-Myon, Yongin, Kyunggi-Do, South
Korea
2
Abstract
A newly acquired rhesus macaque was suffering from rapid destruction by necrotizing somatitis on the left
cheek. Self-injury by the affected monkey accelerated acute progressive lesion and caused the loss of structural
and functional cheek pouch.
Immediately after isolation from other monkeys, physical examination, lab work, microorganism culture, and
antibiotic susceptibility test were performed. For the restoration, reconstructive surgery and intensive care
including antibiotics, wound protector, wound healing agents, debridement were applied.
Staphylococcus aureus and Enterococcus faecalis were isolated from the culture of the lesion. Antibiotic
susceptibility test revealed Methicillin-resistant Staphylococus aureus infection. Vancomycin and ampicillinsulbactam were effective regimen as antibiotic treatment and also reconstructive surgery was performed
following negative result of bacterial culture. rhEGF accelerated the wound healing process and it’s topical
application had favorable effect on the noma lesion.
Simian noma associated with Methicillin-resistant Staphylococcus aureus has not been reported in nonhuman
primate so far. Although this disease is hard to cure for rapid and destructive progress, aggressive treatments led
to successful restoration of acute necrotic somatitis lesion in the rhesus macaque.
Keywords: MRSA, noma, rhesus macaque, enterococcus feacalis, rhEGF