Lab Manual and Workbook in Microbiology 11th Edition by Josephine Morello ,Paul Granato,Verna Morton

Exercise 13

Community-Acquired Methicilin-Resistant Staphylococcus
The following case reported by the Centers for Disease Control and Prevention. They illustrate the emerging problem of community-acquired methicillin-resistant Staphylococcus aureus , as well as clinical and laboratory features of staphylococcal infection.
A 16-month-old girl was brought to a local hospital with fever, hemoptysis (bloody sputum), and respiratory distress. The day before admission, she had a productive cough and a 2-cm papule on her lower lip. A chest X-ray showed infiltrates in the left lower lobe of her lung and a pleural effusion (fluid in the pleural space). She was treated with a cephalosporin-type antimicrobial and a methicillin-type antimicrobial. Shortly after arriving at the hospital, her blood pressure dropped, and she was intubated and treated with vancomycin. Despite supportive efforts, she died after 7 days from progressive cerebral edema (brain swelling) and multiorgan failure. The patient's blood, sputum, and pleural fluid grew MRSA that was multidrug susceptible.
What was the likely source of the original Staphylococcus infection in each patient?