Titre du document / Document title

Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children

Auteur(s) / Author(s)

FRANK A. L. ⁽¹⁾ ; MARCINAK J. F. ⁽¹⁾ ; MANGAT P. D. ⁽¹⁾ ; SCHRECKENBERGER P. C. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Pediatrics, College of Medicine, University of Illinois at Chicago, Chicago, IL, ETATS-UNIS
⁽²⁾ Department of Pathology, College of Medicine, University of Illinois at Chicago, Chicago, IL, ETATS-UNIS

Résumé / Abstract

Background. Recognition of children with community-acquired (CA) infections caused by clindamycin-susceptible, methicillin-resistant Staphylococcus aureus (MRSA) prompted a retrospective study in two Chicago hospitals conducted from 1987 through 1997. Methods. Laboratory records of MRSA isolates, antibiotic susceptibilities and information from patient medical records were reviewed. Results. One hundred eleven MRSA isolates from 103 children were studied with 51 isolates CA and 77 susceptible to clindamycin. The CA infections were less frequently associated with prior surgery (P = 0.0039) or a foreign body (P = 0.0001), and clindamycin-susceptible MRSA infections were less frequently associated with a foreign body (P = 0.001) compared with nosocomially acquired or clindamycin-resistant MRSA infections. Clindamycin-susceptible MRSA sources were mostly skin, wound or abscess (69%). Soft tissue diagnoses predominated (70%), but 16% were serious invasive infections. Ninety percent of clindamycin-susceptible MRSA were susceptible to erythromycin and/or trimethoprim-sulfamethoxazole. Antibiotic undertreatment (45%) or overtreatment (17%) of children with the clindamycin-susceptible MRSA occurred, but clindamycin appeared to be effective when used. Conclusion. The impact of these organisms could be substantial if they become more frequent or widespread. S. aureus is a potential pathogen in large numbers of pediatric patients; microbiologic evaluation and both presumptive and definitive treatment of all these children may need to be changed.

Revue / Journal Title

The Pediatric infectious disease journal   ISSN 0891-3668   CODEN PIDJEV 

Source / Source

1999, vol. 18, n^o11, pp. 993-1000 (35 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1987) (Revue)

Mots-clés anglais / English Keywords

Staphylococcal infection ; Staphylococcus aureus ; Community acquired infection ; Drug susceptibility test ; Antibacterial agent ; Antibiotic ; Risk factor ; Child ; Statistical study ; Chemotherapy ; Treatment ; Clindamycin ; Choice ; Bacteriosis ; Infection ; Micrococcaceae ; Micrococcales ; Bacteria ; Human ;

Mots-clés français / French Keywords

Staphylococcie ; Staphylococcus aureus ; Infection communautaire ; Test sensibilité médicamenteuse ; Antibactérien ; Antibiotique ; Facteur risque ; Enfant ; Etude statistique ; Chimiothérapie ; Traitement ; Clindamycine ; Choix ; Souche résistante méticilline ; Bactériose ; Infection ; Micrococcaceae ; Micrococcales ; Bactérie ; Homme ;

Mots-clés espagnols / Spanish Keywords

Estafilococia ; Staphylococcus aureus ; Infección comunitaria ; Prueba sensibilidad medicamentosa ; Antibacteriano ; Antibiótico ; Factor riesgo ; Niño ; Estudio estadístico ; Quimioterapia ; Tratamiento ; Clindamicina ; Elección ; Bacteriosis ; Infección ; Micrococcaceae ; Micrococcales ; Bacteria ; Hombre ;

Localisation / Location

INIST-CNRS, Cote INIST : 20356, 35400008046584.0110