Rate of methicillin-resistant Staphylococcus aureus in pediatric emergency departments in Spain

Ferrer-Bergua, Lucía Garriga; Senra, Anna María Borrull; Velasco, Carmen Pérez; Valladares, Cristina Montero; Vallduriola, Iris Collazo; Villanueva, Sandra Moya; Velasco, Roberto; Alba, Marta Pérez; Espí, Mercedes de la Torre

doi:10.1016/j.anpede.2021.06.015

Cited by 3 publications

(5 citation statements)

References 29 publications

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“…[24][25][26] It can be due to the fact that in our study only SAB were studied, and the incidence could be higher if we studied MRSA isolation in other locations. 11 As it is known, MRSA bacteremia is associated with having risk factors 16 (in our results, 2 of 4 patients with MRSA isolation in the bloodstream had risk factors). Hamdy et al 27 found that methicillin resistance was an independent risk factor for developing acute complications.…”

Section: Discussionsupporting

confidence: 49%

“…10 In recent research from Spain, a culture rate [skin abscess, blood culture (BC), conjunctiva, skin, ear and others] of 16.6% of the total isolates of S. aureus was reported. 11 This rate is highest in skin abscesses (29.3%), while the prevalence in BC is around 12.5%. 11 MRSA rate in BC is higher in the United States (35.8%), where S. aureus —MRSA and methicillin sensible together—is nowadays the most isolated pathogen (25.0%) in hospitalized children, 12 just like in Australia and New Zealand.…”

mentioning

confidence: 97%

“…11 This rate is highest in skin abscesses (29.3%), while the prevalence in BC is around 12.5%. 11 MRSA rate in BC is higher in the United States (35.8%), where S. aureus —MRSA and methicillin sensible together—is nowadays the most isolated pathogen (25.0%) in hospitalized children, 12 just like in Australia and New Zealand. 13…”

mentioning

confidence: 97%

“…11 This rate is highest in skin abscesses (29.3%), while the prevalence in BC is around 12.5%. 11 MRSA rate in BC is higher in the United States (35.8%), where S. aureus-MRSA and methicillin sensible together-is nowadays the most isolated pathogen (25.0%) in hospitalized children, 12 just like in Australia and New Zealand. 13 Although S. aureus is a well-known cause of bacteremia in febrile children, to our knowledge, no large series have analyzed SAB in pediatric emergency departments (PEDs).…”

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confidence: 97%

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Staphylococcus aureus Bacteremia in the Pediatric Emergency Department and Predictors of Poor Outcome

Suárez-Bustamante Huélamo,

Alonso-Cadenas,

Cortés

et al. 2023

Pediatric Infectious Disease Journal

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Background: Staphylococcus aureus has become the leading cause of bacteremia among previously healthy children older than 5 years. Methods: We aimed to describe the infants presenting to pediatric emergency departments and diagnosed with S. aureus bacteremia (SAB) and identify predictors (clinical and laboratory variables) of poor outcome (complications, sequelae or death). We performed an observational study and subanalysis of a multicenter prospective registry, including every patient under the age of 18 years with a positive blood culture obtained at any of the 22 participating Spanish pediatric emergency departments between 2011 and 2016. We considered chronic diseases, immunosuppressive treatment and the presence of mechanical devices as risk factors for SAB. Results: Of the 229 patients with SAB, 176 (76.9%) were previously healthy, 192 (83.8%) had a normal pediatric assessment triangle and 158 (69.0%) had an associated focal infection (mainly osteoarticular infection, skin and soft tissue infection and pneumonia). Fifty-three patients (23.1%) had 1 or more risk factors for SAB. Thirty-one (13.5%) presented a poor outcome, including 4 deaths (1.7%). A poor outcome was more common in patients with SAB risk factors [odds ratio (OR): 7.0; 95% CI: 3.2–15.4], abnormal PAT (OR: 5.9; 95% CI: 2.6–13.3), elevated procalcitonin (OR: 1.2; 95% CI: 1.05–1.3) and C-reactive protein, the latter being the only independent predictor of poor outcome (OR: 1.01; 95% CI: 1.01–1.02). Conclusions: Overall, children with SAB are previously healthy, appear well, and have an associated focal infection. One out of 7 had a poor outcome, with C-reactive protein being the only predictor identified.

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Section: Discussionsupporting

confidence: 49%

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confidence: 97%

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confidence: 97%

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confidence: 97%

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Staphylococcus aureus Bacteremia in the Pediatric Emergency Department and Predictors of Poor Outcome

Suárez-Bustamante Huélamo,

Alonso-Cadenas,

Cortés

et al. 2023

Pediatric Infectious Disease Journal

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“…Higher rates of MRSA were found in specimens of suppurative skin lesions and in children from abroad or with a history of previous MRSA infection. The study concluded that early drainage of suppurative skin lesions is essential and switching to an antibiotic with MRSA should be considered [ 41 ]. In a retrospective observational study of pediatric clinical cultures performed between 2005 and 2017, although methicillin resistance decreased, resistance to clindamycin and trimethoprim-sulfamethoxazole increased significantly, especially among isolates of community origin [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study on Staphylococcus aureus Resistance Profile and Antibiotic Use in a Pediatric Population

Buonsenso,

Giaimo,

Pata

et al. 2023

Antibiotics

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The growing phenomenon of antibiotic resistance and the presence of limited data concerning the pediatric area prompted us to focus on Staphylococcus aureus infection in this study, its antibiotic resistance profile, and the therapeutic management of affected children. We conducted a retrospective study by collecting clinical data on infants and children with antibiogram-associated S. aureus infection. We enrolled 1210 patients with a mean age of 0.9 years. We analyzed the resistance patterns and found 61.5% resistance to oxacillin, 58.4% resistance to cephalosporins, 41.6% resistance to aminoglycosides, and 38.3% resistance to fluoroquinolones. Importantly, we found no resistance to glycopeptides, a key antibiotic for MRSA infections whose resistance is increasing worldwide. We also found that the main risk factors associated with antibiotic resistance are being aged between 0 and 28 days, the presence of devices, and comorbidities. Antibiotic resistance is a growing concern; knowing the resistance profiles makes it possible to better target the therapy; however, it is important to use antibiotics according to the principles of antibiotic stewardship to limit their spread.

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Fire Needle Combined Topical Mupirocin for the Treatment of Simple Skin Abscesses in Pediatric Patients: A Case Series

Li¹,

Zhu²,

Cao³

et al. 2023

IDR

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Background: Skin abscesses are a common skin condition usually caused by bacterial infections and their incidence is increasing in children. Its current management strategy is still mainly incision and drainage, sometimes with antibiotics. In pediatric patients, surgical incision and drainage of skin abscesses is challenging compared to in adults because of their specific age and psychological characteristics and high aesthetic requirements. Therefore, it is important to seek better treatment options. Patients and methods: We reported 17 cases of skin abscesses in pediatric patients aged 1 to 9 years. Ten cases had lesions on the face and neck and 7 cases on the trunk and limbs. They all received treatment based on fire needle combined with topical mupirocin. Results:The lesions of all 17 pediatric patients healed within 4 to 14 days, with a median time of 6 days, and all achieved satisfactory results with no scarring left behind. No adverse events were observed in all patients, and no recurrence occurred within 4 weeks. Conclusion: For skin abscesses in pediatric patients, early application of a combination therapy based on fire needle is convenient, aesthetic, economical, safe and clinically important as an alternative to incision and drainage, and deserves further clinical promotion.

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Rate of methicillin-resistant Staphylococcus aureus in pediatric emergency departments in Spain

Cited by 3 publications

References 29 publications

Staphylococcus aureus Bacteremia in the Pediatric Emergency Department and Predictors of Poor Outcome

Staphylococcus aureus Bacteremia in the Pediatric Emergency Department and Predictors of Poor Outcome

Retrospective Study on Staphylococcus aureus Resistance Profile and Antibiotic Use in a Pediatric Population

Fire Needle Combined Topical Mupirocin for the Treatment of Simple Skin Abscesses in Pediatric Patients: A Case Series

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