Articles

Invasive community-acquired Staphylococcus aureus among pediatric population of Eastern Iran

Abstract

Background and Objective: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly reported worldwide. We aimed to determine the frequency of invasive CA-MRSA in children admitted to the pediatric wards of Imam Reza and Ghaem hospitals of Mashhad, Iran.
Materials and Methods: In this retrospective study, data regarding S. aureus isolates from pediatric patients’ sterile body sites (i.e. blood‚ joint, bone and lymph node aspiration) were retrieved in a time period from March 2006 to March 2012. Disc diffusion data was analyzed to determine the resistance pattern of the isolates, and differentiation between community- acquired and nosocomial S. aureus was done according to CDC guidelines.
Results: Twenty three invasive community-acquired S. aureus isolates from sterile body sites were identified, of which seventeen (74%) were CA-MRSA. The CA-MRSA isolates showed high frequency of resistance to non-β-lactam antibiotics (71% to erythromycin‚ 53% to co-trimoxazole, 44% to gentamicin and 36% to ciprofloxacin).
Conclusion: In this study, the majority of invasive community-acquired S. aureus isolates were found to be CA-MRSA. Therefore, we recommend that primary treatment should be with antibiotics such as clindamycin, vancomycin, linezolid or daptomycin for any invasive infection suspected to be caused by S. aureus in these two hospitals.

Kaplan SL. Epidemiology and clinical spectrum of methicillin-resistant Staphylococcus aureus infections in children. 2013. Up to date. Available at: http://www. ptodate.com/contents/epidemiology-and-clinical- spectrum-of-methicillin-resistant-staphylococcus-aureus- infections-in-children. Accessed October 11, 2013.

Sattler CA, Mason EOJ, Kaplan SL. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin- resistant versus methicillin-susceptible Staphylococcus aureus infection in children. Pediatr Infect Dis J 2002;21: 910-917.

Moran GJ, Krishnadasan A, Gorwitz RJ, Fosheim GE, McDougal LK, Carey RB, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med 2006; 355: 666-674.

Deurenberg RH, Vink C, Kalenic S, Friedrich AW, Bruggeman CA, Stobberingh EE. The molecular evolution of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect 2007; 13: 222-235.

Skiest DJ, Brown K, Cooper TW, Hoffman-Roberts H, Mussa HR, Elliott AC. Prospective comparison of methicillin-susceptible and methicillin-resistant community-associated Staphylococcus aureus infections in hospitalized patients. J Infect 2007; 54: 427-434.

DavidMZ,DaumRS.Community-associatedmethicillin- resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010; 23: 616-687.

David MZ, Crawford SE, Boyle-Vavra S, Hostetler MA, Kim DC, Daum RS. Contrasting pediatric and adult methicillin-resistant Staphylococcus aureus isolates. Emerg Infect Dis 2006; 12: 631-637.

File TMJ. Impact of community-acquired methicillin- resistant Staphylococcus aureus in the hospital setting. Cleve Clin J Med 2007; 74: S6-S11.

Al-Tawfiq JA. Incidence and epidemiology of methicillin-resistant Staphylococcus aureus infection in a Saudi Arabian Hospital, 1999-2003. Infect Control Hosp Epidemiol 2006; 27: 1137-1139.

Oğuz VA, Yapar N, Sezak N, Cavuş SA, Kurutepe S, Peksel H, et al. The rate of inducible clindamycin resistance and susceptibilities to other antimicrobial agents in staphylococci. Mikrobiyol Bul 2009; 43: 37-44.

Nagaraju U, Bhat G, Kuruvila M, Pai GS, Jayalakshmi, Babu RP. Methicillin-resistant Staphylococcus aureus in community-acquired pyoderma. Int J Dermatol 2004;43: 412-414.

Fang YH, Hsueh PR, Hu JJ, Lee PI, Chen JM, Lee CY, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children in northern Taiwan. J Microbiol Immunol Infect 2004; 37: 29-34.

Bukharie HA, Abdelhadi MS. The epidemiology of methicillin-resistant Staphylococcus aureus at a Saudi university hospital. Microb Drug Resist 2001; 7: 413-416.

Fortunov RM, Hulten KG, Hammerman WA, Mason EOJ, Kaplan SL. Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics 2006; 118: 874-881.

Gutierrez K. Bone and joint infections in children.Pediatr Clin North Am 2005; 52: 779-794.

Mediavilla JR, Chen L, Mathema B, Kreiswirth BN. Global epidemiology of community-associated methicillin resistant Staphylococcus aureus (CA- MRSA). Curr Opin Microbiol 2012; 15: 588-595.

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IssueVol 6 No 2 (2014) QRcode
SectionArticles
Keywords
Staphylococcus aureus child community-acquired infections methicillin resistance

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How to Cite
1.
Sasan M, Donyadide N, Askari E, Naderi-Nasab M. Invasive community-acquired Staphylococcus aureus among pediatric population of Eastern Iran. Iran J Microbiol. 1;6(2):84-86.