Introduction: 

Methicillin-susceptible Staphylococcus aureus (MSSA) infections cause diseases ranging from localized skin infections to serious invasive infections. Neonates are immunosuppressed, placing them at increased risk for MSSA infections, including staphylococcal scalded skin syndrome (SSSS), a rare severe skin presentation of MSSA.

Clinical Findings: 

We present a case series of 3 preterm infants with SSSS receiving care at a level 3 neonatal intensive care unit.

Primary Diagnosis: 

The infants presented with symptoms of sepsis, including temperature instability, apnea, and bradycardia episodes. The infants had peeling skin at sites of external pressure, including peripheral intravenous (IV) sites, under dressings, or where devices had been in contact with skin.

Interventions: 

The infants were soaked in a tub with gel baby wash and water to remove leads without traumatizing the skin. Laboratory values were drawn, and cultures were obtained. Wound care was provided using mupirocin, soft silicone mesh wound contact layer, and soft cotton bandage gauze. Supportive respiratory care was provided, and IV antibiotics were administered.

Outcomes: 

The infants were discharged to their homes with intact skin. One infant experienced a loss of pigment that persisted several weeks. All patients were without scarring by early childhood.

Practice Recommendations: 

Thorough assessment and careful hygiene of neonates' skin is crucial. MSSA is an infection that can appear on the skin. It is important to quickly diagnose and treat this type of infection, especially when it presents as a localized pustule, boil, tear, peeling, or crust before it becomes systemic.

中文翻译：

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葡萄球菌性烫伤皮肤综合征、识别和伤口护理：病例报告系列

介绍： 

甲氧西林敏感金黄色葡萄球菌(MSSA) 感染可引起从局部皮肤感染到严重侵袭性感染等多种疾病。新生儿的免疫受到抑制，导致他们感染 MSSA 的风险增加，包括葡萄球菌烫伤皮肤综合征(SSSS)，这是一种罕见的严重 MSSA 皮肤表现。

临床结果： 

我们提出了一个病例系列，其中包括 3 名患有 SSSS 的早产儿，他们在 3 级新生儿重症监护病房接受护理。

初步诊断： 

婴儿出现败血症症状，包括体温不稳定、呼吸暂停和心动过缓发作。婴儿在外部压力部位出现皮肤剥落，包括外周静脉（IV）部位、敷料下或设备与皮肤接触的部位。

干预措施： 

将婴儿浸泡在装有凝胶婴儿洗液和水的浴缸中，以在不损伤皮肤的情况下去除导线。绘制实验室值并获得培养物。使用莫匹罗星、柔软的硅胶网状伤口接触层和柔软的棉绷带纱布提供伤口护理。提供支持性呼吸护理，并静脉注射抗生素。

结果： 

婴儿被送回家，皮肤完好无损。一名婴儿出现了持续数周的色素流失。所有患者在幼儿期都没有留下疤痕。

实践建议： 

对新生儿皮肤进行彻底的评估和仔细的卫生至关重要。MSSA 是一种可能出现在皮肤上的感染。快速诊断和治疗此类感染非常重要，特别是当它在全身性感染之前表现为局部脓疱、疖肿、撕裂、脱皮或结痂时。