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Characterization of community-acquired Staphylococcus aureus infections in children.
Ann Pharmacother 2007; 41(9):1361-7AP

Abstract

BACKGROUND

Limited data exist concerning characteristics of community-acquired Staphylococcus aureus infections (CA-SAI) in central and eastern Kentucky.

OBJECTIVE

To describe the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections from January 1, 2004 through December 31, 2005, compare the number of CA-MRSA infections between years, and contrast treatment interventions and antibiotic susceptibility patterns of CA-SAI.

METHODS

A concurrent and retrospective study was conducted in 125 patients less than 18 years of age with CA-SAI admitted to the hospital/clinic based on criteria from the Centers for Disease Control and Prevention. Data on demographics, length of stay, antibiotic therapy, and antibiotic susceptibilities were collected.

RESULTS

Seventy patients were included for analysis (CA-MRSA, n = 51; community-acquired methicillin-susceptible S. aureus [CA-MSSA], n = 19). No statistically significant differences were noted between the number of CA-MRSA infections and the total CA-SAI (9/15 in 2004 vs 42/55 in 2005; p = 0.15). Approximately 75% of patients with CA-SAI were admitted to the hospital with no significant difference in length of stay. Ninety percent of CA-SAI were skin and soft tissue infections. There was a significant difference between groups with cutaneous abscesses (CA-MRSA, n = 37 vs CA-MSSA, n = 6; p = 0.002). Greater than 95% of all isolates were susceptible to vancomycin and trimethoprim/sulfamethoxazole. Half of CA-MRSA patients received inappropriate antibiotic therapy with beta-lactam antibiotics or clindamycin without confirmatory disk diffusion test. Twenty-five (49%) patients with CA-MRSA received surgical debridement (S/D) and/or incision and drainage (I/D) with concomitant antibiotic therapy. Four patients with CA-MRSA were rehospitalized for subsequent infections; all 4 received appropriate antibiotic therapy.

CONCLUSIONS

A noticeable increase in CA-MRSA infections with cutaneous abscess between 2004 and 2005 was noted. In patients receiving inappropriate antibiotic therapy, treatment success was attributed to concomitant S/D and I/D. Further analysis should focus on the impact of antibiotic therapy alone or in combination with S/D and I/D on the incidence of subsequent CA-MRSA infections.

Authors+Show Affiliations

University of Kentucky Chandler Medical Center, Lexington, KY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17652124

Citation

Johnson, Peter N., et al. "Characterization of Community-acquired Staphylococcus Aureus Infections in Children." The Annals of Pharmacotherapy, vol. 41, no. 9, 2007, pp. 1361-7.
Johnson PN, Rapp RP, Nelson CT, et al. Characterization of community-acquired Staphylococcus aureus infections in children. Ann Pharmacother. 2007;41(9):1361-7.
Johnson, P. N., Rapp, R. P., Nelson, C. T., Butler, J. S., Overman, S., & Kuhn, R. J. (2007). Characterization of community-acquired Staphylococcus aureus infections in children. The Annals of Pharmacotherapy, 41(9), pp. 1361-7.
Johnson PN, et al. Characterization of Community-acquired Staphylococcus Aureus Infections in Children. Ann Pharmacother. 2007;41(9):1361-7. PubMed PMID: 17652124.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of community-acquired Staphylococcus aureus infections in children. AU - Johnson,Peter N, AU - Rapp,Robert P, AU - Nelson,Christopher T, AU - Butler,J S, AU - Overman,Sue, AU - Kuhn,Robert J, Y1 - 2007/07/24/ PY - 2007/7/27/pubmed PY - 2007/10/5/medline PY - 2007/7/27/entrez SP - 1361 EP - 7 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 41 IS - 9 N2 - BACKGROUND: Limited data exist concerning characteristics of community-acquired Staphylococcus aureus infections (CA-SAI) in central and eastern Kentucky. OBJECTIVE: To describe the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections from January 1, 2004 through December 31, 2005, compare the number of CA-MRSA infections between years, and contrast treatment interventions and antibiotic susceptibility patterns of CA-SAI. METHODS: A concurrent and retrospective study was conducted in 125 patients less than 18 years of age with CA-SAI admitted to the hospital/clinic based on criteria from the Centers for Disease Control and Prevention. Data on demographics, length of stay, antibiotic therapy, and antibiotic susceptibilities were collected. RESULTS: Seventy patients were included for analysis (CA-MRSA, n = 51; community-acquired methicillin-susceptible S. aureus [CA-MSSA], n = 19). No statistically significant differences were noted between the number of CA-MRSA infections and the total CA-SAI (9/15 in 2004 vs 42/55 in 2005; p = 0.15). Approximately 75% of patients with CA-SAI were admitted to the hospital with no significant difference in length of stay. Ninety percent of CA-SAI were skin and soft tissue infections. There was a significant difference between groups with cutaneous abscesses (CA-MRSA, n = 37 vs CA-MSSA, n = 6; p = 0.002). Greater than 95% of all isolates were susceptible to vancomycin and trimethoprim/sulfamethoxazole. Half of CA-MRSA patients received inappropriate antibiotic therapy with beta-lactam antibiotics or clindamycin without confirmatory disk diffusion test. Twenty-five (49%) patients with CA-MRSA received surgical debridement (S/D) and/or incision and drainage (I/D) with concomitant antibiotic therapy. Four patients with CA-MRSA were rehospitalized for subsequent infections; all 4 received appropriate antibiotic therapy. CONCLUSIONS: A noticeable increase in CA-MRSA infections with cutaneous abscess between 2004 and 2005 was noted. In patients receiving inappropriate antibiotic therapy, treatment success was attributed to concomitant S/D and I/D. Further analysis should focus on the impact of antibiotic therapy alone or in combination with S/D and I/D on the incidence of subsequent CA-MRSA infections. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/17652124/Characterization_of_community_acquired_Staphylococcus_aureus_infections_in_children_ L2 - http://journals.sagepub.com/doi/full/10.1345/aph.1K118?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -