Community-acquired Methicillin-Resistant Staphylococcus Aureus in Children With No Identified Predisposing Risk

JAMA. 1998 Feb 25;279(8):593-8. doi: 10.1001/jama.279.8.593.

Abstract

Context: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently.

Objectives: To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation.

Design: Retrospective review of medical records.

Patients: Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995).

Setting: The University of Chicago Children's Hospital.

Main outcome measures: Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease.

Results: The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100000 admissions in 1988-1990 to 259 per 100000 admissions in 1993-1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children without an identified risk (P=.02).

Conclusions: These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Community-Acquired Infections
  • DNA, Bacterial / analysis
  • Electrophoresis, Gel, Pulsed-Field
  • Female
  • Genes, Bacterial
  • Hospitalization
  • Humans
  • Infant
  • Male
  • Methicillin Resistance*
  • Microbial Sensitivity Tests
  • Polymerase Chain Reaction
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections* / drug therapy
  • Staphylococcal Infections* / epidemiology
  • Staphylococcal Infections* / microbiology
  • Staphylococcus aureus / drug effects*
  • Staphylococcus aureus / genetics

Substances

  • DNA, Bacterial