Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children have increased considerably in our area. In this study, we prospectively examined the epidemiological, clinical and molecular profile of CA-MRSA infections in children in central Greece. A total of 198 staphylococcal strains were isolated from patients with community-acquired infections over a 28-month period and 88 (44%) were found to be methicillin-resistant. Most patients with CA-MRSA had skin and soft-tissue infections (73%). Hospitalisation and surgery were more commonly required for patients with MRSA strains (p = 0.001 and p < 0.001, respectively). The presence of Panton-Valentine leukocidin (PVL) genes was identified in 28/41 (68%) CA-MRSA strains. All PVL(+) strains were found to carry a staphylococcal chromosomal cassette (SCC) mec element type IV and belonged to a single electrophoretic type similar to the European multi-locus sequence type 80 (ST80). The recent increase in CA-MRSA infections in children in our area is largely associated with the spread of the ST80 clone and their clinical characteristics are similar to those described in other parts of the world where different MRSA clones predominate.

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The majority of paediatric hand and finger amputations could be prevented in Greece, particularly among preschoolers, by a single product modification, namely door closure systems, coupled with improved supervision. Paediatricians should incorporate this advice into their routine child-safety counselling. This country-specific profile supports the need for maintaining similar databases as an indispensable tool for assisting decision-making and preventing disabling and costly injuries.

Salmonella osteomyelitis in children is an uncommon condition, typically associated with hemoglobinopathies or other underlying disorders. Only few cases have been reported in children without predisposing factors. We describe 4 cases of Salmonella osteomyelitis in otherwise healthy children. Since treatment duration is expected to be prolonged, the practice of direct inoculation of aspirates into blood culture bottles appears to be essential for diagnosis and targeted therapy.

This is a case of Scedosporium apiospermum skeletal infection in a 10-year-old immunocompetent girl whose chief complaint was left knee swelling and pain. The child had a history of a bicycle accident two months before with a resultant deep penetrating trauma. Systematic administration of broad-spectrum antibiotics for 10 days was used, with no clinical improvement. Magnetic Resonance Imaging and arthrotomy of the affected joint revealed findings suggestive of osteomyelitis. Empirical intravenous antimicrobial therapy was instituted for a total of two months but one month after completion of antibacterial therapy the child returned to the hospital because of persistent knee swelling and pain. Following a new arthrotomy, Scedosporium apiospermum was isolated. The patient was cured with intravenous administration of voriconazole without any side effects and has no evidence of relapse after four years of follow-up.