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Arch Argent Pediatr. 2018 Feb 1;116(1):e47-e53. doi: 10.5546/aap.2018.eng.e47.

Community-acquired methicillin-resistant Staphylococcus aureus infections: hospitalization and case fatality risk in 10 pediatric facilities in Argentina.

[Article in English, Spanish; Abstract available in Spanish from the publisher]

Author information

1
Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires. angelagentile21@gmail.com.
2
Hospital de Niños Ricardo Gutiérrez, Ciudad Autónoma de Buenos Aires.
3
Hospital de Niños Víctor Vilela, Rosario, Santa Fe.
4
Hospital de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires.
5
Hospital de Niños de San Justo, Buenos Aires.
6
Hospital del Niño Jesús, San Miguel de Tucumán.
7
Hospital de Niños Dr. Héctor Quintana, Jujuy.
8
Hospital de Niños Eva Perón, San Fernando del Valle de Catamarca.
9
Hospital de Niños Orlando Alassia, Santa Fe.
10
Hospital Pediátrico Humberto Notti, Guaymallén, Mendoza.
11
Hospital Pediátrico J. Pablo II, Corrientes.

Abstract

in English, Spanish

INTRODUCTION:

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are prevalent both in Argentina and worldwide, and they may have a severe clinical course.

OBJECTIVES:

To estimate the hospitalization rate and case fatality risk factors of CA-MRSA infection.

METHODS:

Cross-sectional, analytical study. All patients < 15 years old with community-acquired Staphylococcus aureus (CA-SA) infections admitted to 10 pediatric facilities between January 2012 and December 2014 were included.

RESULTS:

Out of 1141 patients with CA-SA, 904 (79.2%) had CA-MRSA. The rate of hospitalization of CA-MRSA cases (per 10 000 discharges) among patients < 5 years old was 27.6 in 2012, 35.2 in 2013, and 42.7 in 2014 (p = 0.0002). The 2-4-year-old group was the most affected one: 32.2, 49.4, and 54.4, respectively (p = 0.0057). The clinical presentations included skin and soft tissue infections: 66.2%, pneumonia: 11.5%, sepsis/bacteremia: 8.5%, osteomyelitis: 5.5%, arthritis: 5.2%, psoas abscess: 1.0%, pericarditis/endocarditis: 0.8%, meningitis: 0.6%, and other: 0.7%. In terms of antibiotic resistance, 11.1% had resistance to erythromycin; 8.4%, to gentamicin; and 0.6%, to trimethoprim-sulfamethoxazole. All strains were susceptible to vancomycin. The case fatality rate was 2.2% and associated risk factors were (odds ratio [95% confidence interval]) age > 8 years (2.78, 1.05-7.37), pneumonia (6.37, 2.3717.09), meningitis (19.53, 2.40-127.87), and sepsis/bacteremia (39.65, 11.94-145.55).

CONCLUSIONS:

The rate of CA-MRSA infection was high; the rate of hospitalization increased in the 2013-2014 period; the 2-4-year-old group was the most affected one. A higher case fatality risk was observed among patients > 8 years old and those with the clinical presentations of pneumonia, meningitis, and sepsis.

KEYWORDS:

Fatality; Pediatrics; Risk factors; Staphylococcal infections

PMID:
29333818
DOI:
10.5546/aap.2018.eng.e47
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