Contrasting pediatric and adult methicillin-resistant Staphylococcus aureus isolates.
We performed a prospective study of all inpatient and outpatient methicillin-resistant Staphylococcus aureus (MRSA) isolates identified at the University of Chicago Hospitals from November 2003 through November 2004. Differences in resistance to non-beta-lactam antimicrobial drugs were determined after stratification of the 578 MRSA isolates into 4 groups by patient age (pediatric vs. adult) and onset location (community vs. hospital). Non-beta-lactam resistance was significantly greater among the 288 adult than the 177 pediatric community-associated isolates for erythromycin (93.2 vs. 87.0%, p = 0.03), clindamycin (51.8 vs. 7.3%, p<0.001), ciprofloxacin (62.1 vs. 10.7%, p<0.001), gentamicin (11.1 vs. 1.1%, p<0.001), and tetracycline (19.9 vs. 6.4%, p<0.001). In contrast, hospital-associated MRSA isolates from children and adults had similar rates of non-beta-lactam antimicrobial drug resistance. In our region, clindamycin is an appropriate empiric therapy of community-associated MRSA infection in children but should be used with caution in adults.
David
Michael Z
MZ
University of Chicago, Chicago, Illinois 60637, USA. mdavid@medicine.bsd.uchicago.edu
Crawford
Susan E
SE
Boyle-Vavra
Susan
S
Hostetler
Mark A
MA
Kim
Daniel C
DC
Daum
Robert S
RS
D000328:Adult; D000375:Aging; D002648:Child; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013997:Time Factors