Risk factors associated with Methicillin-resistant Staphylococcus aureus infection in children

Senthilkumar, K.; Biswal, Niranjan; Sistla, Sujatha

doi:10.1007/s13312-015-0562-9

Cited by 11 publications

(15 citation statements)

References 12 publications

(9 reference statements)

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“…The median overall hospital stay was 10 days (IQR 6-17 days) for MRSA and 8 days (IQR 5-15 days) for MSSA; 14% (77/551) of infections required admission to PICU with stays of 8 days (IQR 6-11 days) for MRSA and 6 days (IQR 3-13 days) for MSSA. Of the total number of patients, 53% (41/77) received assisted ventilation with a median of 7 [4][5][6][7][8][9] days for MRSA and 9 [4][5][6][7][8][9][10][11] days for MSSA while inotropic agents were used in 77% (48/62) of the patients for 4 [3][4][5][6][7] days with MRSA and 6 2-9 days with MSSA. With respect to the number of days of hospitalization, a longer stay in hospital was only found in the group of MRSA OIs (P = 0.0006), and no significant differences were found in the number of days spent in the PICU.…”

Section: Resultsmentioning

confidence: 99%

Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics

Camacho-Cruz

Gutiérrez

Brand-López

et al. 2021

Pediatric Infectious Disease Journal

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Background: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) has changed in recent years. The present article is intended to establish differences between clinical, laboratory and imaging findings and outcomes of MSSA and MRSA infections, as well as among subgroups of infection such as skin and soft tissue infection, osteoarticular, bacteremia or pneumonia in a pediatric population from Bogota, Colombia. Methods: Retrospective cohort study using clinical records of patients under 18 years of age treated at the participating centers in Bogota, Colombia, between 2014 and 2018. The first positive S. aureus culture was studied. MSSA and MRSA were compared. The χ 2 test, Fisher exact test, and Kruskal-Wallis test were calculated, and the statistical significance was presented using the difference and its 95% CI. Results: Five hundred fifty-one patients were included; 211 (38%) corresponded to MRSA and 340 (62%) to MSSA for a total of 703 cultures. A significantly higher probability of having an MSSA infection than MRSA was found in patients with previous heart disease (3.3% vs. 0.5%), neurologic disease (5.9% vs. 2.5%), recent major surgeries (11% vs. 5%) or who has an implanted device (11% vs. 4%). In contrast, in severe MRSA infections (bacteremia, osteoarticular infections and pneumonia), a higher rate of complications was seen (admission to the pediatric intensive care unit, mechanical ventilation and vasoactive support), and in osteoarticular MRSA, more than 1 surgery per case was seen (89% vs. 61%). Laboratory results and mortality were similar. Conclusions: MRSA was associated with a more severe course in bacteremia, osteoarticular infections and pneumonia. Some classical risk factors associated with MRSA infections were found to be related to MSSA. In general, with the exception of skin and soft tissue infection, there was an increased risk of pediatric intensive care unit admission and mechanical and inotropic support with MRSA in a pediatric population.

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Section: Resultsmentioning

confidence: 99%

Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics

Camacho-Cruz

Gutiérrez

Brand-López

et al. 2021

Pediatric Infectious Disease Journal

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“…All of the 40 studies were considered for qualitative as well as the quantitative synthesis of etiological agents. Ultimately, only 34 of 40 studies were included in the MRSA meta-analysis, 8,9,15 -46 as the remaining 6 studies did not include data relevant to MRSA (4 efficacy studies, 1 study that described heteroresistance to vancomycin among methicillin-resistant S. aureus isolates, and 1 survey wherein no exact data on prevalence were presented). 47 -52 Table 1 represents the characteristics of the studies included in the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 10 studies 8,16,18,23,28,31,36,38,41,46 identified risk factors and co-morbidities, including diabetes, tuberculosis, malignancy, leprosy, extremes of age, group-house inhabitants, high mean body temperature (101.80°F), history of preceding illness/upper respiratory tract infections/trauma, abnormal laboratory values (hemoglobin [<9.5 g%], erythrocyte sedimentation rate [>35 mm/h], c-reactive protein [>32 mg/dL], leucocytes (>14 000 cells/10 9 L), absolute neutrophil count [(>65%]), immuno-compromised status, hospitalization in the last 3 months, present intake/history of antibiotics, history of surgical procedures, history of alcohol intake and smoking, history of intravenous drugs, history of corticosteroid intake, history of mucocutaneous candidiasis, history of dermatitis, history of sexually transmitted infections, socio-economic status, chronic kidney disease, heart disease, chronic obstructive pulmonary disease, rheumatoid arthritis, MRSA carriage (nasal or axillary or perineal or hand carriage in patients), prolonged duration of hospital stay, and irrational use/over prescription of antibiotics.…”

Section: Resultsmentioning

confidence: 99%

A Systemic Literature Review and Meta-Analysis Reporting the Prevalence and Impact of Methicillin-ResistantStaphylococcus aureusInfection in India

2020

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Aim and objective: This systematic review and meta-analysis was conducted to assess the prevalence, burden and epidemiology of methicillin-resistant S. aureus (MRSA). This systemic review was also aimed to highlight the challenges in the diagnosis and management of methicillin-resistant S. aureus (MRSA) in India (for all age groups). We also examined the published literature on the available treatment options and the role of prevention in the management of MRSA in India. By summarizing the currently available data, our objectives were to highlight the need for the prevention of MRSA infections and also emphasize the role of vaccination in the prevention of MRSA infections in India. Methodology: Electronic databases such as PubMed and databases of the National Institute of Science Communication and Information Resources and Indian Council of Medical Research Embase were searched for relevant literature published from 2005/01/01 to 2020/05/13 in English language, according to the predefined inclusion and exclusion criteria. A manual search was also conducted using the key term “MRSA ‘or’ Methicillin Resistant Staphylococcus aureus ‘and’ India.” An independent reviewer extracted data from the studies using a structured Microsoft Excel spreadsheet, and a meta-analysis of proportion for MRSA prevalence with a corresponding 95% confidence interval (CI) for all included individual studies were performed. Result: A total of 34 studies involving 16 237 patients were included in the final meta-analysis. The pooled proportion of patients with MRSA infection was 26.8% (95% CI: 23.2%-30.7%). The MRSA infection was more prevalent among male patients (60.4%; 95% CI: 53.9%-66.5%) as compared to female patients (39.6%; 95% CI: 33.5%-46.1%), while the prevalence of MRSA was higher among adults (18 years and above; 32%; 95% CI: 5%-80%) in comparison to pediatric patients (0-18 years; 68%; 95% CI: 20%-94.8%). The degree of heterogeneity was found to be significant. Conclusion: The prevalence of MRSA in India was relatively high at 27% with a higher proportion observed among men aged >18 years. The high prevalence of MRSA infections in India necessitates the implementation of surveillance and preventive measures to combat the spread of MRSA in both hospital and community settings.

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“…Impetigo was the most common bacterial infection similar to the published data[217] followed by Staphylococcal scalded skin syndrome (SSSS). Methicillin-resistant Staphylococcus aureus (MRSA) prevalence in children was 21.9% in a hospital-based Indian study,[19] which was seen in only two of our children (SSSS and Staphylococcal scarlatina). Fatality is reported in MRSA-induced SSSS,[20] stressing the importance to recognize and treat appropriately.…”

Section: Discussionmentioning

confidence: 92%

Pediatric cutaneous emergencies and their outcome: Study from a tertiary care center in South India

Sathishkumar

Udhayakumar

Adhikari

et al. 2019

Indian Dermatol Online J

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Background:Skin problems are commonly encountered in the pediatric emergency department (PED). Although there are a few studies on the prevalence and spectrum of skin conditions in children attending the PED, only limited information is available on the outcome of the children with skin-related ailments requiring hospitalization.Aim:To study the clinical profile of skin manifestations in children presenting to the PED over a period of one year and assess the impact of skin lesions on the clinical outcome.Materials and Methods:All children <16 years of age attending the PED were screened and children with skin lesions were referred to the dermatologist for further evaluation, and those admitted were followed up until discharge. Children with skin lesions were categorized into seven subsets based on their diagnosis. Outcomes evaluated were duration of hospital stay, associated systemic inflammatory response syndrome (SIRS), and mortality.Results:Of the 24,324 patients screened, 203 (0.83%) had skin lesions, of whom 158 (77.83%) were discharged from the PED. Forty five (22.16%) patients required admission of whom 2 (0.99%) died. Inflammatory disorders were the most common, 102 (50.24%), followed by infections in 91 (44.82%) patients. Among the hospitalized patients, 25 (55.6%) had SIRS, which included infections in 14 (56%), vasculitis in 5 (20%), and urticaria in 3 (12%) patients. Two patients with SIRS died and the causes were purpura fulminans and febrile exanthem of probable viral etiology.Conclusion:Our study highlights the spectrum of pediatric cutaneous emergencies and their outcome. A subset of patients can present with severe skin ailments and SIRS in whom early diagnosis and prompt treatment can impact the outcome.

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Risk factors associated with Methicillin-resistant Staphylococcus aureus infection in children

Cited by 11 publications

References 12 publications

Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics

Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics

A Systemic Literature Review and Meta-Analysis Reporting the Prevalence and Impact of Methicillin-ResistantStaphylococcus aureusInfection in India

Pediatric cutaneous emergencies and their outcome: Study from a tertiary care center in South India

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