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

被引：0

作者：

Gentile, Angela ^{[1
]}

Bakir, Julia ^{[1
]}

Ensinck, Gabriela ^{[2
]}

Cancellara, Aldo ^{[3
]}

Casanueva, Enrique V. ^{[4
]}

Firpo, Veronica ^{[5
]}

Caruso, Martin ^{[6
]}

Lucion, Maria F. ^{[1
]}

Santillan Iturres, Alejandro ^{[7
]}

Molina, Fabiana ^{[8
]}

Abate, Hector J. ^{[9
]}

Gane, Andrea Gajo ^{[10
]}

Lopez Papucci, Santiago ^{[2
]}

机构：

[1] Hosp Ninos Dr Ricardo Gutierrez, Buenos Aires, DF, Argentina

[2] Hosp Ninos Victor J Vilela, Rosario, Santa Fe, Argentina

[3] Hosp Ninos Pedro de Elizalde, Buenos Aires, DF, Argentina

[4] Hosp Ninos San Justo, Buenos Aires, DF, Argentina

[5] Hosp Nino Jesus, San Miguel De Tucuman, Tucuman, Argentina

[6] Hosp Ninos Dr Hector Quintana, San Salvador De Jujuy, Argentina

[7] Hosp Ninos Eva Peron, San Fernando Del Valle C, Argentina

[8] Hosp Ninos Orlando Alassia, Santa Fe, Argentina

[9] Hosp Pediat Humberto Notti, Guaymallen, Mendoza, Argentina

[10] Hosp Pediat J Pablo II, Corrientes, Argentina

来源：

ARCHIVOS ARGENTINOS DE PEDIATRIA | 2018年 / 116卷 / 01期

关键词：

staphylococcal infections; fatality; risk factors; pediatrics; PANTON-VALENTINE LEUKOCIDIN; STREPTOCOCCUS-PNEUMONIAE; INVASIVE INFECTIONS; CHILDREN; DISEASE; COLONIZATION; BACTEREMIA; CARRIAGE; HEALTHY; CLONE;

D O I：

10.5546/aap.2018.eng.e47

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

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, 2.37-17.09), 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.

引用

页码：E47 / E53

页数：7