TY - JOUR
T1 - Community-associated methicillin-resistant Staphylococcus aureus infections among children in the western Galilee region
T2 - the beginning of an epidemic?
AU - Glikman, Daniel
PY - 2009/11
Y1 - 2009/11
N2 - BACKGROUND: Community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections were reported in the United States in the 1990's among healthy children, without traditional risk factors for infection with MRSA. CA-MRSA is now epidemic in the United States causing superficial infections and severe invasive disease. There is a paucity of data about CA-MRSA disease in the pediatric Israeli population and the common belief is that CA-MRSA disease is rare. OBJECTIVE: Prospective surveillance for CA-MRSA strains among hospitalized children at the Western Galilee Hospital in Israel over a 1-year period. METHODS: Staphylococcus aureus isolates were collected prospectively in 2007-8. CA-MRSA strains were defined as MRSA isolated in the first 72 hours of hospitalization with non-multi-drug resistant profile (resistant to < 3 non-beta-lactam antimicrobials). Patients' clinical characteristics were collected from medical charts. RESULTS: Five of 103 (4.8%) children were identified with Staphylococcus aureus isolates that were infected with CA-MRSA strains. All five had MRSA isolated from skin abscesses; their median age was 2.5 years. Skin and soft tissue infections were evident among 59 children infected with Staphylococcus aureus, 5 of which were CA-MRSA strains (8.5%). The calculated prevalence of CA-MRSA infections among pediatric patients within the study period was 76 cases per 100,000 admissions. All isolates were susceptible to vancomycin, linezolid, rifampin, trimethoprim sulfamethoxazole, and clindamycin. Four of the 5 children presented with recurrent MRSA infections. Possible risk factors for CA-MRSA were noted among 3 patients: participation in contact sports, atopic dermatitis, and family history of MRSA infections. CONCLUSIONS: A significant rate of CA-MRSA disease exists among children in the Western Galilee Region. CA-MRSA disease presents as recurrent skin and soft tissue infections. Awareness and recognition by culturing, mainly of skin lesions, is the first crucial step in investigating the magnitude of CA-MRSA disease. The old school thinking of MRSA being solely a hospital-based pathogen, in patients with frequent exposure to the healthcare system, is no longer valid in Israel.
AB - BACKGROUND: Community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections were reported in the United States in the 1990's among healthy children, without traditional risk factors for infection with MRSA. CA-MRSA is now epidemic in the United States causing superficial infections and severe invasive disease. There is a paucity of data about CA-MRSA disease in the pediatric Israeli population and the common belief is that CA-MRSA disease is rare. OBJECTIVE: Prospective surveillance for CA-MRSA strains among hospitalized children at the Western Galilee Hospital in Israel over a 1-year period. METHODS: Staphylococcus aureus isolates were collected prospectively in 2007-8. CA-MRSA strains were defined as MRSA isolated in the first 72 hours of hospitalization with non-multi-drug resistant profile (resistant to < 3 non-beta-lactam antimicrobials). Patients' clinical characteristics were collected from medical charts. RESULTS: Five of 103 (4.8%) children were identified with Staphylococcus aureus isolates that were infected with CA-MRSA strains. All five had MRSA isolated from skin abscesses; their median age was 2.5 years. Skin and soft tissue infections were evident among 59 children infected with Staphylococcus aureus, 5 of which were CA-MRSA strains (8.5%). The calculated prevalence of CA-MRSA infections among pediatric patients within the study period was 76 cases per 100,000 admissions. All isolates were susceptible to vancomycin, linezolid, rifampin, trimethoprim sulfamethoxazole, and clindamycin. Four of the 5 children presented with recurrent MRSA infections. Possible risk factors for CA-MRSA were noted among 3 patients: participation in contact sports, atopic dermatitis, and family history of MRSA infections. CONCLUSIONS: A significant rate of CA-MRSA disease exists among children in the Western Galilee Region. CA-MRSA disease presents as recurrent skin and soft tissue infections. Awareness and recognition by culturing, mainly of skin lesions, is the first crucial step in investigating the magnitude of CA-MRSA disease. The old school thinking of MRSA being solely a hospital-based pathogen, in patients with frequent exposure to the healthcare system, is no longer valid in Israel.
UR - http://www.scopus.com/inward/record.url?scp=77949891074&partnerID=8YFLogxK
M3 - מאמר
C2 - 20027978
AN - SCOPUS:77949891074
SN - 0017-7768
VL - 148
SP - 761-765, 794, 793
JO - Harefuah
JF - Harefuah
IS - 11
ER -