Revista chilena de infectología
versión impresa ISSN 0716-1018
PAGANINI, M, Hugo et al. Community onset of methicillin resistant Staphylococcus aureus infections in previously healthy or health care-associated children en Argentina. Rev. chil. infectol. [online]. 2009, vol.26, n.5, pp.406-412. ISSN 0716-1018. http://dx.doi.org/10.4067/S0716-10182009000600002.
Introduction: Community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) are prevalent in several countries of the world. These infections seem to differ clinically from those occurring within the health care system (HCS-MRSA). Objective: To compare clinical characteristics of infections by CA-MRSA and HCA-MRSA in the same communitty. Material and Methods: Prospective, multicentric and comparative study. Children with clinically and microbiologicaly documented CA-MRSA were included. Results: Between 11/2006 and 11/2007, 840 infections caused by S. aureus were diagnosed. Of them 582 (68%) were community-acquired. Among these 356 (61%) were CA-MRSA. In this group, 75 (21%) were HCA-MRSA and 281 (79%) CA-MRSA. The median age was 36months (range: 1-201). Chronic skindisease (13) and chronic disease of CNS (9) were the underlying disease predominant. Children with CA-MRSAhad more frequency of previous antibiotic treatment (63 vs 34%) and previous medical consult (76 vs 52%), invasive procedures (31 vs 8%), surgery (15 vs 0,3%) and fever (94 vs 74%) (p = <05). Children with CA-MRSAhad subcutaneous abscesses (34 vs 15%) (p = <.05) more frequently. Bacteremia and sepsis rate was similar in both groups (21 vs 18%) and 17 vs 11%) respectively) (p = NS). Antibiotic resistance was more frequent in children with HCA-MRSA: Rifampin (7 vs 1%), trimethoprim-sulphametoxazole (7 vs 1%) and clindamycin (25 vs 9%) (p = <.05). Four children (5%) with HCA-MRSA infections died and 3 (1%) mCA-MRSAgroup (p = .05). Conclusión: Children with HCA-MRSA infections more frequent antibiotic resistance than CA-MRSA should be reconsider the empiric antibiotic treatment of community-acquired infections in children in our área.
Palabras clave : Community-acquired; Staphylococcus aureus; methicillin-resistant; children.