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Arch Argent Pediatr. 2008 Oct;106(5):397-403. doi: 10.1590/S0325-00752008000500005.

[Community-acquired methicillin-resistant Staphylococcus aureus infections in children: multicenter trial].

[Article in Spanish]

Author information

1
Hospital Prof. Dr. Juan P. Garrahan, Ciudad Autónoma de Buenos Aires. hpaganini@intramed.net.ar

Abstract

INTRODUCTION:

Methicillin-resistant Staphylococcus aureus (MRSA) isolates are increasingly frequent causes of skin and soft-tissue infections or invasive infections in many communities. Local data are scarce.

OBJECTIVE:

To determine the frequency, clinical features and outcome of infections caused by MRSA.

MATERIAL AND METHODS:

Prospective and multicentric study of surveillance for community-acquired S. aureus infections in children from Argentina. Infections meeting the definition of community-acquired were identified. Demographic and clinical data were collected. Antibiotic susceptibilities were determined in the clinical microbiology laboratory with the methodology of the NCCLS.

RESULTS:

From November 2006 to November 2007, 840 S. aureus infections were diagnosed, 447 of them were community-acquired. One hundred and thirty-five children with underlying disease or previous hospital admission were excluded. Two hundred and eighty one (62%) infections were community-acquired MRSA (CA-MRSA). The median age of children was 36 months (r:1-201), 60% were male. Among the CA-MRSA isolates, 62% were obtained from children with skin and soft-tissue infections, and 38% from children with invasive infections. Of them, osteomyelitis, arthritis, empyema and pneumonia were prevalent. Eigthteen percent of children had bacteremia and 11% sepsis. The rate of clindamycin resistance of CA-MRSA isolates was 10% and 1% for trimethoprim-sulfamethoxazole. Only 31% of children had appropriate treatment at admission. The median time of treatment delayed was 72 h. The median time of parenteral treatment was 6 days (r:1-70). In 72% of patients surgical treatment was required. Three children died (1%).

CONCLUSIONS:

CA-MRSA isolates account for a high percentage and number of infections in children of Argentina. Community surveillance of CA-MRSA infections is critical to determine the appropriate empiric antibiotic treatment for either local or invasive infections. Clindamycin resistance was under 15% in the strains tested. Clindamycin should be use when CA-MRSA infection is suspected in children.

PMID:
19030638
DOI:
10.1590/S0325-00752008000500005
[Indexed for MEDLINE]
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