Community Acquired Methicillin Resistant Staphylococcus Aureus (CA-MRSA) Infection in Paediatric Subcutaneous Abscesses in Pakistan

Abstract

Introduction: Staphylococcus aureus is one of the common pathogens of the human body. Previously a change in its sensitivity pattern was observed in which it became methicillin resistant but this strain was usually seen in hospital settings or in immunocompromised patients. Recently a changing trend has been observed in which a new variant of methicillin resistant staphylococcus aureus (MRSA) is being isolated specially in pediatric patients, who do not have any risk factors. This strain is labeled as community acquired MRSA. Aims & Objectives: To find the frequency of Community Acquired Methicillin-resistant Staphylococcus Aureus (CAMRSA) in paediatric sub-cutaneous abscesses. Place and duration of study: A cross-sectional prospective study was conducted in Department of Paediatric Surgery Shaikh Zayed Medical Complex, Lahore from January 2017 till December 2020. Material & Methods: All the patients from 7 days to 14 years of age from both genders having subcutaneous abscesses were included. Neonates having hospital stay of more than 24 hours at birth were excluded. Patients having abscess secondary to any surgical intervention, recent hospitalization or trauma were also excluded. Patients were divided into four groups based on age. Pus samples were taken for culture & sensitivity. Data analysis was performed using SPSS version 20. Results: There were 143 patients and 75 (52.4%) of them were males. Patient were divided in groups on the basis of age. The most common location of abscess was head & neck (43.4%) followed by lower limbs and buttocks (30.1%). The most common organism to grow was Staph. aureus (75%) and out of these 107 cases 70 (65.4%) had MRSA. No growth was obtained in 30 (21%) patients. Other less common organisms were seen in 6 (4%) cases. In less than 1 month of age of patients 76% had MRSA which was significantly higher than in other age groups (pvalue 0.047). Conclusion: The frequency of CA-MRSA in paediatric subcutaneous abscesses is on the rise across the globe and more cases of invasive infections are being reported. So, population-based studies are required to assess the prevalence of this bacteria amongst paediatric population of Pakistan.