Introduction:Staphylococcus aureus is one of the most common pathogens in health care facilities and in the community, and can cause invasive infections, sepsis, and death. Despite progress in preventing methicillin-resistant S. aureus (MRSA) infections in health care settings, assessment of the problem in both health care and community settings is needed. Further, the epidemiology of methicillin-susceptible S. aureus (MSSA) infections is not well described at the national level.Methods: Data from the Emerging Infections Program (EIP) MRSA population surveillance (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) and from the Premier and Cerner Electronic Health Record databases (2012)(2013)(2014)(2015)(2016)(2017) were analyzed to describe trends in incidence of hospital-onset and community-onset MRSA and MSSA bloodstream infections and to estimate the overall incidence of S. aureus bloodstream infections in the United States and associated in-hospital mortality. Results:In 2017, an estimated 119,247 S. aureus bloodstream infections with 19,832 associated deaths occurred. During 2005-2012 rates of hospital-onset MRSA bloodstream infection decreased by 17.1% annually, but the decline slowed during 2013-2016. Community-onset MRSA declined less markedly (6.9% annually during [2005][2006][2007][2008][2009][2010][2011][2012][2013][2014][2015][2016], mostly related to declines in health care-associated infections. Hospital-onset MSSA has not significantly changed (p = 0.11), and community-onset MSSA infections have slightly increased (3.9% per year, p<0.0001) from 2012 to 2017. Conclusions and Implications for Public Health Practice:Despite reductions in incidence of MRSA bloodstream infections since 2005, S. aureus infections account for significant morbidity and mortality in the United States. To reduce the incidence of these infections further, health care facilities should take steps to fully implement CDC recommendations for prevention of device-and procedure-associated infections and for interruption of transmission. New and novel prevention strategies are also needed.Corresponding author: Athena P. Kourtis, apk3@dc.gov,

Key Points Question Among children with a COVID-19 diagnosis, what conditions are common, and which are associated with severe COVID-19 illness? Findings In this cross-sectional study of 43 465 patients aged 18 years or younger with COVID-19, more than one-quarter had 1 or more underlying condition; asthma, obesity, neurodevelopmental disorders, and certain mental health conditions were most common. Certain conditions as well as medical complexity were associated with a higher risk of severe COVID-19 illness. Meaning These findings expand the knowledge available regarding children with COVID-19 and could inform pediatric clinical practice and public health priorities, such as prevention and mitigation of COVID-19.

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WHAT'S KNOWN ON THIS SUBJECT:We previously alerted the ACIP to preliminary evidence of a twofold increased risk of febrile seizures after MMRV when compared with separate MMR and varicella vaccines after monitoring with the VSD RCA surveillance system. WHAT THIS STUDY ADDS:Using VSD data on twice as many vaccines, we examined the effect of MMRV on risk of seizure and describe here the postvaccination risk interval for increased fever and febrile seizures after vaccination. abstract OBJECTIVE: In February 2008, we alerted the Advisory Committee on Immunization Practices to preliminary evidence of a twofold increased risk of febrile seizures after the combination measles-mumps-rubella-varicella (MMRV) vaccine when compared with separate measles-mumps-rubella (MMR) and varicella vaccines. Now with data on twice as many vaccine recipients, our goal was to reexamine seizure risk after MMRV vaccine. METHODS: Using 2000 -2008Vaccine Safety Datalink data, we assessed seizures and fever visits among children aged 12 to 23 months after MMRV and separate MMR ϩ varicella vaccines. We compared seizure risk after MMRV vaccine to that after MMR ϩ varicella vaccines by using Poisson regression as well as with supplementary regressions that incorporated chart-review results and self-controlled analyses. RESULTS:MMRV vaccine recipients (83 107) were compared with recipients of MMR ϩ varicella vaccines (376 354). Seizure and fever significantly clustered 7 to 10 days after vaccination with all measles-containing vaccines but not after varicella vaccination alone. Seizure risk during days 7 to 10 was higher after MMRV than after MMR ϩ varicella vaccination (relative risk: 1.98 [95% confidence interval: 1.43-2.73]). Supplementary analyses yielded similar results. The excess risk for febrile seizures 7 to 10 days after MMRV compared with separate MMR ϩ varicella vaccination was 4.3 per 10 000 doses (95% confidence interval: 2.6 -5.6). CONCLUSIONS:Among 12-to 23-month-olds who received their first dose of measles-containing vaccine, fever and seizure were elevated 7 to 10 days after vaccination. Vaccination with MMRV results in 1 additional febrile seizure for every 2300 doses given instead of separate MMR ϩ varicella vaccines. Providers who recommend MMRV should communicate to parents that it increases the risk of fever and seizure over that already associated with measles-containing vaccines.