Literature DB >> 19030638

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

Hugo Paganini1, María P Della Latta, Beatriz Muller Opet, Gustavo Ezcurra, Macarena Uranga, Clarisa Aguirre, Gabriela Ensinck, Marys Kamiya de Macarrein, María R Miranda, Cristina Ciriaci, Claudia Hernández, Lidia Casimir, María J Rial, Norma Schenonne, Estela Ronchi, María del C Rodríguez, Fabiana Aprile, Catalina De Ricco, Viviana García Saito, Claudia Vrátnica, Laura Pons, Adriana Ernst, Sandra Morinigo, Marcelo Toffoli, Celia Bosque, Victoria Monzani, Andrea Mónaco, José L Pinheiro, María del P López, Leonardo Maninno, Claudia Sarkis.   

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.

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Year:  2008        PMID: 19030638     DOI: 10.1590/S0325-00752008000500005

Source DB:  PubMed          Journal:  Arch Argent Pediatr        ISSN: 0325-0075            Impact factor:   0.635


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Review 2.  Incidence, characteristics, and outcomes of patients with bone and joint infections due to community-associated methicillin-resistant Staphylococcus aureus: a systematic review.

Authors:  K Z Vardakas; I Kontopidis; I D Gkegkes; P I Rafailidis; M E Falagas
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3.  Spread of epidemic MRSA-ST5-IV clone encoding PVL as a major cause of community onset staphylococcal infections in Argentinean children.

Authors:  Claudia Sola; Hugo Paganini; Ana L Egea; Alejandro J Moyano; Analia Garnero; Ines Kevric; Catalina Culasso; Ana Vindel; Horacio Lopardo; José L Bocco
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4.  Current role of community-acquired methicillin-resistant Staphylococcus aureus among children with skin and soft tissue infections.

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5.  Prospective multicenter study of community-associated skin and skin structure infections due to methicillin-resistant Staphylococcus aureus in Buenos Aires, Argentina.

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Journal:  PLoS One       Date:  2013-11-20       Impact factor: 3.240

Review 6.  Community-genotype methicillin-resistant Staphylococcus aureus skin and soft tissue infections in Latin America: a systematic review.

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  6 in total

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