Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children.
BACKGROUND
Community-acquired, methicillin-resistant (CA-MRSA) infections in children are increasing in frequency for unknown reasons.


OBJECTIVE
To compare the presence of risk factors for methicillin resistance between patients with CA-MRSA and community-acquired methicillin-susceptible (CA-MSSA) infection and to compare the presence of risk factors among household contacts of the patients from both groups. To compare the demographic and clinical characteristics between children with CA-MRSA and CA-MSSA infection.


METHODS
Prospective observational study conducted between February 2, 2000 and November 14, 2000, excluding the month of May and the period between September 2 and October 15.


METHODS
Texas Children's Hospital, Houston, TX; inpatients and outpatients with community-acquired infection.


METHODS
Proportion of MRSA among all community-acquired infections. The presence of risk factors associated with methicillin resistance among patients, and their household contacts, with CA-MRSA and CA-MSSA.


RESULTS
The monthly rates of methicillin resistance of varied between 35 and 51%. CA-MSSA isolates were associated with deep-seated infections significantly more often (30%) than CA-MRSA isolates (11%; P= 0.01). CA-MRSA isolates were generally susceptible to clindamycin and trimethoprim-sulfamethoxazole and resistant to erythromycin. There were no significant differences in the exposure to risk factors between children with CA-MRSA and CA-MSSA infection. No significant risk factors for CA-MRSA were identified among household contacts.


CONCLUSIONS
MRSA is an established, community-acquired pathogen in our area. This necessitates a change in empiric therapy of infections suspected to be caused by.
Sattler
Carlos A
CA
Department of Pediatrics, Baylor College of Medicine, and the Infectious Disease Laboratory, Texas Children's Hospital, Houston, TX 77030, USA.
Mason
Edward O
EO
Kaplan
Sheldon L
SL
D000293:Adolescent; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D015999:Multivariate Analysis; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents