Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children
Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children
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DOI：
10.1097/00006454-200210000-00005
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发表时间：
2002-10-01
影响因子：
3.6
通讯作者：
Kaplan, SL
中科院分区：
文献类型：
--
作者：
Sattler, CA;Mason, EO;Kaplan, SL
上下文。社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）在儿童中的感染频率正在增加，原因不明。比较CA-MRSA患者与社区获得性甲氧西林敏感金黄色葡萄球菌（CA-MSSA）感染甲氧西林耐药的危险因素存在情况，并比较两组患者家庭接触者中存在的危险因素。比较CA-MRSA和CA-MSSA感染儿童的人口学和临床特征。前瞻性观察研究于2000年2月2日至11月14日进行，不包括5月和9月2日至10月15日期间。环境和病人。德克萨斯州休斯顿的德克萨斯儿童医院；社区获得性金黄色葡萄球菌感染的住院和门诊患者。主要结果测量。MRSA在所有社区获得性金黄色葡萄球菌感染中的比例。CA-MRSA和ca - mssa患者及其家庭接触者中存在与甲氧西林耐药相关的危险因素。金黄色葡萄球菌每月对甲氧西林的耐药率在35% ~ 51%之间。CA-MSSA分离株与深部感染相关的频率（30%）明显高于CA-MRSA分离株（11%,P = 0.01）。CA-MRSA分离株普遍对克林霉素和甲氧苄啶-磺胺甲恶唑敏感，对红霉素耐药。CA-MRSA和CA-MSSA感染儿童在危险因素暴露方面无显著差异。在家庭接触者中未发现CA-MRSA的显著危险因素。在我们地区，耐甲氧西林金黄色葡萄球菌是一种既定的、社区获得的病原体。这就需要改变对怀疑由金黄色葡萄球菌引起的感染的经验性治疗。
Context. Community-acquired, methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children are increasing in frequency for unknown reasons.Objectives. To compare the presence of risk factors for methicillin resistance between patients with CA-MRSA and community-acquired methicillin-susceptible S. aureus (CA-MSSA) infection and to compare the presence of risk factors among household contacts of the patients from both groups. To compare the demographic and clinical characteristics between children with CA-MRSA and CA-MSSA infection.Design. Prospective observational study conducted between February 2, 2000 and November 14, 2000, excluding the month of May and the period between September 2 and October 15.Setting and patients. Texas Children's Hospital, Houston, TX; inpatients and outpatients with community-acquired S. aureus infection.Main outcome measures. Proportion of MRSA among all community-acquired S. aureus infections. The presence of risk factors associated with methicillin resistance among patients, and their household contacts, with CA-MRSA and CA-MSSA.Results. The monthly rates of methicillin resistance of S. aureus varied between 35 and 51%. CA-MSSA isolates were associated with deep-seated infections significantly more often (30%) than CA-MRSA isolates (11%; P = 0.01). CA-MRSA isolates were generally susceptible to clindamycin and trimethoprim-sulfamethoxazole and resistant to erythromycin. There were no significant differences in the exposure to risk factors between children with CA-MRSA and CA-MSSA infection. No significant risk factors for CA-MRSA were identified among household contacts.Conclusions. MRSA is an established, community-acquired pathogen in our area. This necessitates a change in empiric therapy of infections suspected to be caused by S. aureus.