Staphylococcus aureus’un Neden Olduğu Deri ve Yumuşak Doku Enfeksiyonu Olan Pediatrik Hastalarda Parenteral Antibiyotiklerin Klinik Sonuçları

Öz

Bu çalışmanın amacı, hastanede yatan çocuk hastalarda Staphylococcus aureus’a bağlı deri ve yumuşak doku enfeksiyonlarının klinik ve laboratuvar özelliklerini belirlemek ve parenteral antibiyotiklere göre klinik sonuçları karşılaştırmaktır. Bu tek merkezli retrospektif çalışmada, Eylül 2019 – Eylül 2022 tarihleri arasında Ankara Bilkent Şehir Hastanesi Çocuk Hastanesi’nde S. aureus ilişkili deri ve yumuşak doku enfeksiyonu tanısı alarak tedavi edilen 1 ay–18 yaş arası hastalar analiz edilmiştir. Çalışmaya toplam 89 hasta dahil edilmiştir. Enfeksiyonların %60,7’si metisiline duyarlı (MSSA; n=54), %39,3’ü metisiline dirençli (MRSA; n=35) S. aureus kaynaklıydı. MRSA grubunda santral kateter ilişkili enfeksiyon, önceki hastaneye yatış ve komplikasyon oranları MSSA grubuna göre anlamlı olarak daha yüksekti (%34,1 vs. %11,1; %62,9 vs. %24,1; %28,6 vs. %5,6; p=0,010; p=0,010; p=0,003). MRSA grubunda vankomisin ve teikoplanin tedavisi arasında klinik sonuçlar açısından fark izlenmedi. MSSA grubunda ise beta-laktam/beta-laktamaz inhibitörü ve üçüncü kuşak sefalosporin alan hastalarda klinik sonuçlar benzerdir. Ancak ampisilin-sulbaktam alan hastalarda nüks ve komplikasyon oranları piperasilin-tazobaktam alanlara göre anlamlı şekilde daha düşüktü (%0, %0 vs. %25, %25; p=0,029). MRSA ilişkili deri ve yumuşak doku enfeksiyonlarının tedavisinde teikoplanin, vankomisine benzer klinik sonuçları nedeniyle makul bir seçenek olabilir. MSSA ilişkili enfeksiyonların tedavisinde ise ampisilin-sulbaktam, piperasilin-tazobaktam ve üçüncü kuşak sefalosporinler tatmin edici sonuçları nedeniyle uygun tedavi seçenekleri olabilir..

Anahtar Kelimeler

• Staphylococcus aureus
• deri ve yumuşak doku enfeksiyonları (DYDE)
• parenteral antibiyotikler
• klinik sonuçlar
• çocuklar

Clinical Outcomes of Parenteral Antibiotics Used in Staphylococcus Aureus-Related Skin and Soft Tissue Infections in Pediatric Hospitalized Patients

Öz

This study aimed to determine the clinical and laboratory characteristics of hospitalized pediatric patients with skin and soft tissue infections (SSTIs) associated with Staphylococcus aureus and to compare parenteral antibiotic therapies in terms of clinical outcomes. This single-center retrospective study analyzed patients aged 1 month to 18 years who were treated for S. aureus-associated SSTIs at Ankara Bilkent City Children's Hospital between September 2019 and September 2022. A total of 89 patients were included. Infections were caused by methicillin-susceptible (S. aureus, MSSA; n=54, 60.7%) and methicillin-resistant (S. aureus, MRSA; n=35, 39.3%). Compared to the MSSA group, the MRSA group had significantly higher rates of central venous catheter-related infections, prior hospitalizations, and complications (34.1% vs. 11.1%, 62.9% vs. 24.1%, and 28.6% vs. 5.6%, respectively; p=0.010, p=0.010, p=0.003). No significant difference in clinical outcomes was observed between patients treated with vancomycin or teicoplanin in the MRSA group. In the MSSA group, clinical outcomes were similar between patients who received beta-lactam/beta-lactamase inhibitors and third-generation cephalosporins. However, those treated with ampicillin-sulbactam had lower recurrence and complication rates compared to those treated with piperacillin-tazobactam (0% and 0% vs. 25% and 25%, respectively; p=0.029). Teicoplanin may be a reasonable option for treating MRSA-related SSTIs due to comparable clinical outcomes to vancomycin. For MSSA-related SSTIs, beta-lactam/beta-lactamase inhibitors such as ampicillin-sulbactam, piperacillin-tazobactam, and third-generation cephalosporins may also be appropriate treatment options with satisfactory results.

Anahtar Kelimeler

• Staphylococcus aureus
• skin and soft tissue infections (SSTIs)
• parenteral antibiotics
• clinical outcomes
• children

Kaynakça

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