Araştırma Makalesi

Clinical characteristics and resistance patterns of Staphylococcus aureus infections in children at a tertiary care hospital in southern Turkey

Cilt: 47 Sayı: 2 30 Haziran 2022
PDF İndir
TR EN

Clinical characteristics and resistance patterns of Staphylococcus aureus infections in children at a tertiary care hospital in southern Turkey

Abstract

Purpose: The aim of this study was to evaluate the clinical and demographic characteristics and resistance patterns to antistaphylococcal antibiotics of Staphylococcus aureus (S. aureus) isolates, which is a leading cause of invasive infections in children. Materials and Methods: Patients who were under 18 years of age and who had S. aureus growth in abscess, wound, blood, cerebrospinal fluid, joint fluid and any other sterile body fluid cultures, who were followed up at Children’s Health and Diseases Clinic in between July 2018 and July 2020 were included in the study. Results: A total of 135 patients and cultures were included in the study. Community-acquired S. aureus (CA-SA) infection was present in 105 (77.7%) patients and hospital-acquired S. aureus (HA-SA) infections in 30 (22.3%). S. aureus was most commonly detected in skin and soft tissue infections. Skin and soft tissue infections were more common in patients with community-acquired disease, whereas bacteremia was more common in patients with nosocomial infection. Methicillin-resistant S. aureus (MRSA) isolates was encountered in 53.3% of all patients; Clindamycin resistance was found in 20% of all staphylococcal isolates and the ratio of mupirocin resistance was 14.4%.55.8% of all CA-SA and 46.7% of all HA-SA isolates were MRSA. Penicillin, mupirocin, erythromycin, and tetracycline resistance were significantly higher in MRSA isolates as compares to non-MRSA isolates. Mupirocin resistance was significantly higher in CA-SA isolates. The median length of hospital stay was 12 days. Length of hospital stay, duration of intravenous antibiotics use, mortality, and clindamycin resistance were significantly higher in patients with HA-MRSA infections. While overall mortality was 2.2% in patients with S. aureus infections, when evaluated separately, it was 10% in patients with HA-SA infections. Conclusion: Our CA-MRSA rates are quite high as compared to other reports, and clindamycin and mupirocin resistance seems to be an important problem in our region. Taking appropriate cultures at the right time is important in determining resistance patterns and guiding empirical treatment regimens.

Keywords

Staphylococcus aureus , Child , Clinical Characteristics , Antibiotic resistance

Kaynakça

  1. 1. Kaplan SL HK, Mason EO. Staphylococcus aureus Infections (Coagulase-Positive Staphylococci). In: Cherry JD KS, Steinbach WJ, Hotez PJ, editor. Feiginand Cherry's Textbook of Pediatric InfectiousDiseases. 8th ed. Philadelphia, PA: Elsevier; 2018. p. 794-806.
  2. 2. Liu C, Bayer A, Cosgrove SE, Daum RS, Fridkin SK, Gorwitz RJ, et al. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children. Clinical infectious diseases. 2011;52(3):e18-e55.
  3. 3. Rybak MJ, LaPlante KL. Community‐associated methicillin‐resistant Staphylococcus aureus: a review. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2005;25(1):74-85.
  4. 4. SL K. Methicillin-resistant Staphylococcus aureus infections in children: Epidemiology and clinical spectrum [15 July 2021]. Available from: http://www.uptodate.com/contents/Methicillin-resistant-Staphylococcus-aureus-infections-in-children:-Epidemiology-and-clinical-spectrum.
  5. 5. Khamash DF, Voskertchian A, Tamma PD, Akinboyo IC, Carroll KC, Milstone AM. Increasing clindamycin and trimethoprim-sulfamethoxazole resistance in pediatric Staphylococcus aureus infections. Journal of the Pediatric Infectious Diseases Society. 2019;8(4):351-3.
  6. 6. Dadashi M, Hajikhani B, Darban-Sarokhalil D, van Belkum A, Goudarzi M. Mupirocin resistance in Staphylococcus aureus: A systematic review and meta-analysis. Journal of global antimicrobial resistance. 2020;20:238-47.
  7. 7. EUCAST. European Committee on Antimicrobial Susceptibility Testing, Clinical breakpoints [cited 2017]. Available from: http:// www.eucast.org/clinical_breakpoints/
  8. 8. Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. Jama. 2007;298(15):1763-71.
  9. 9. Kaplan SL, Hulten KG, Gonzalez BE, Hammerman WA, Lamberth L, Versalovic J, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clinical Infectious Diseases. 2005;40(12):1785-91.
  10. 10. Arikan K, Karadag-Oncel E, Aycan AE, Yuksekkaya S, Sancak B, Ceyhan M. Epidemiologic and Molecular Characteristics of Staphylococcus aureus Strains Isolated From Hospitalized Pediatric Patients. The Pediatric Infectious Disease Journal. 2020;39(11):1002-6.

Kaynak Göster

MLA
Çay, Ümmühan, vd. “Clinical characteristics and resistance patterns of Staphylococcus aureus infections in children at a tertiary care hospital in southern Turkey”. Cukurova Medical Journal, c. 47, sy 2, Haziran 2022, ss. 580-8, https://izlik.org/JA49YB97JE.