Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil?
ABSTRACT Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is spreading worldwide, but little is known about the epidemiology of this pathogen in Brazil. Objective: To evaluate clinical and microbiological features of children with S. aureus infections admitted...
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| Format: | Article |
| Language: | English |
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Elsevier
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| Series: | Brazilian Journal of Infectious Diseases |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000500371&lng=en&tlng=en |
| _version_ | 1819112154835451904 |
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| author | Rolando Paternina-de la Ossa Seila Israel do Prado Maria Célia Cervi Denissani Aparecida Ferrari dos Santos Lima Roberto Martinez Fernando Bellissimo-Rodrigues |
| author_facet | Rolando Paternina-de la Ossa Seila Israel do Prado Maria Célia Cervi Denissani Aparecida Ferrari dos Santos Lima Roberto Martinez Fernando Bellissimo-Rodrigues |
| author_sort | Rolando Paternina-de la Ossa |
| collection | DOAJ |
| description | ABSTRACT Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is spreading worldwide, but little is known about the epidemiology of this pathogen in Brazil. Objective: To evaluate clinical and microbiological features of children with S. aureus infections admitted to a university hospital. Methods: This was a cross-sectional study evaluating the potential risk factors for CA-MRSA, and a retrospective cohort evaluating in-hospital clinical outcomes. To include patients with both community and hospital-associated infections, we screened the results of the microbiological laboratory tests from January 1, 2012, to December 31, 2016. According to the phenotype, we classified the isolates in Methicillin-Susceptible S. aureus (MSSA), Hospital-Associated Methicillin-Resistant S. aureus (HA-MRSA), and CA-MRSA. Clinical data were collected from the patients’ medical records. Results: We identified 279 cases of S. aureus infections (MSSA = 163, CA-MRSA = 69, HA-MRSA = 41). Overall, the incidence density of CA-MRSA and MSSA infections increased while the HA-MRSA incidence density decreased over the study period. CA-MRSA infected patients were more likely to present with skin and soft tissue infections (OR: 2.83, 95%CI: 1.54–5.33, p < 0.001) and osteomyelitis (OR: 4.76; 95%CI: 1.16–22.71, p = 0.014) when compared to MSSA and HA-MRSA infections. Unadjusted case fatality rates were similar between MSSA-infected patients (3.14%, 5/159) and CA-MRSA infected patients (3.80%, 3/79, p = 0.792), while HA-MRSA infected patients were more likely to die in the hospital (12.20%, 5/41, p = 0.013). Conclusions: CA-MRSA is an emergent pediatric pathogen in Brazil. Our results highlight the relevance of choosing an appropriate initial antimicrobial drug for treating children with severe S. aureus infections. |
| first_indexed | 2024-12-22T04:09:00Z |
| format | Article |
| id | doaj.art-19ba8d93dd624a2aa1544d41e4c4a73b |
| institution | Directory Open Access Journal |
| issn | 1678-4391 |
| language | English |
| last_indexed | 2024-12-22T04:09:00Z |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Infectious Diseases |
| spelling | doaj.art-19ba8d93dd624a2aa1544d41e4c4a73b2022-12-21T18:39:34ZengElsevierBrazilian Journal of Infectious Diseases1678-439122537137610.1016/j.bjid.2018.10.276S1413-86702018000500371Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil?Rolando Paternina-de la OssaSeila Israel do PradoMaria Célia CerviDenissani Aparecida Ferrari dos Santos LimaRoberto MartinezFernando Bellissimo-RodriguesABSTRACT Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is spreading worldwide, but little is known about the epidemiology of this pathogen in Brazil. Objective: To evaluate clinical and microbiological features of children with S. aureus infections admitted to a university hospital. Methods: This was a cross-sectional study evaluating the potential risk factors for CA-MRSA, and a retrospective cohort evaluating in-hospital clinical outcomes. To include patients with both community and hospital-associated infections, we screened the results of the microbiological laboratory tests from January 1, 2012, to December 31, 2016. According to the phenotype, we classified the isolates in Methicillin-Susceptible S. aureus (MSSA), Hospital-Associated Methicillin-Resistant S. aureus (HA-MRSA), and CA-MRSA. Clinical data were collected from the patients’ medical records. Results: We identified 279 cases of S. aureus infections (MSSA = 163, CA-MRSA = 69, HA-MRSA = 41). Overall, the incidence density of CA-MRSA and MSSA infections increased while the HA-MRSA incidence density decreased over the study period. CA-MRSA infected patients were more likely to present with skin and soft tissue infections (OR: 2.83, 95%CI: 1.54–5.33, p < 0.001) and osteomyelitis (OR: 4.76; 95%CI: 1.16–22.71, p = 0.014) when compared to MSSA and HA-MRSA infections. Unadjusted case fatality rates were similar between MSSA-infected patients (3.14%, 5/159) and CA-MRSA infected patients (3.80%, 3/79, p = 0.792), while HA-MRSA infected patients were more likely to die in the hospital (12.20%, 5/41, p = 0.013). Conclusions: CA-MRSA is an emergent pediatric pathogen in Brazil. Our results highlight the relevance of choosing an appropriate initial antimicrobial drug for treating children with severe S. aureus infections.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000500371&lng=en&tlng=enStaphylococcus aureusCA-MRSAEpidemiologyClinical featuresChildrenSusceptibility profile |
| spellingShingle | Rolando Paternina-de la Ossa Seila Israel do Prado Maria Célia Cervi Denissani Aparecida Ferrari dos Santos Lima Roberto Martinez Fernando Bellissimo-Rodrigues Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? Brazilian Journal of Infectious Diseases Staphylococcus aureus CA-MRSA Epidemiology Clinical features Children Susceptibility profile |
| title | Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? |
| title_full | Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? |
| title_fullStr | Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? |
| title_full_unstemmed | Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? |
| title_short | Is community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) an emerging pathogen among children in Brazil? |
| title_sort | is community associated methicillin resistant staphylococcus aureus ca mrsa an emerging pathogen among children in brazil |
| topic | Staphylococcus aureus CA-MRSA Epidemiology Clinical features Children Susceptibility profile |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702018000500371&lng=en&tlng=en |
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