Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics : Multicenter Cohort Study Conducted in Bogotá, Colombia, 2014–2018

Medientyp: E-Artikel
Titel: Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics : Multicenter Cohort Study Conducted in Bogotá, Colombia, 2014–2018 : Multicenter Cohort Study Conducted in Bogotá, Colombia, 2014–2018
Beteiligte: Camacho-Cruz, Jhon; Gutiérrez, Iván Felipe; Brand-López, Katherine; Sosa-Rodríguez, Yeni Andrea; Vásquez-Hoyos, Pablo; Gómez-Cortés, Leydi Cristina; Romero-Higuera, Laura Natalia; Rojas-Rojas, Diana Paola; Ortiz-Mendez, Cesar Alfredo; Camacho-Moreno, Germán; Wilches-Cuadros, Maria Angelica; Hernandez-Vargas, Juan Camilo; Velandia-Páez, Jessica Paola; Mancera-Gutiérrez, Luz Angela; Palacios-Ariza, María Alejandra; Beltrán-Higuera, Sandra Jaqueline
Erschienen: Ovid Technologies (Wolters Kluwer Health), 2022
Erschienen in: Pediatric Infectious Disease Journal
Sprache: Englisch
DOI: 10.1097/inf.0000000000003349
ISSN: 0891-3668
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Beschreibung: <jats:sec> <jats:title>Background:</jats:title> <jats:p>The epidemiology of methicillin-resistant <jats:italic toggle="yes">Staphylococcus aureus</jats:italic> (MRSA) and methicillin-susceptible <jats:italic toggle="yes">S. aureus</jats:italic> (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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>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 <jats:italic toggle="yes">S. aureus</jats:italic> culture was studied. MSSA and MRSA were compared. The χ<jats:sup>2</jats:sup> test, Fisher exact test, and Kruskal-Wallis test were calculated, and the statistical significance was presented using the difference and its 95% CI.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>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.</jats:p> </jats:sec>

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