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

Local infection of the trachea in intubated neonates is one of the main ris k factors for development of acquired subglottic stenosis, although its rol e in the pathogenesis is unclear. Methicillin resistant Staphylococcus aure us (MRSA) is often the cause of critical illness in neonatal patients. Two cases are reported of acquired subglottic stenosis following bacterial infe ction of the trachea, suggesting an association with the staphylococcal exo toxin, epidermal cell differentiation inhibitor (EDIN). EDIN-producing MRSA were isolated from purulent tracheal secretions from both infants. Acquire d subglottic stenosis in both cases was probably caused by delayed wound he aling as the result of EDIN inhibition of epithelial cell migration.