title: Prevalence of methicillin-resistant Staphylococcus aureus among children in a region with controlled antimicrobial use.
abstract: Since 2002, we have conducted a series of intervention programs in Sado Island, Japan, to increase awareness of the appropriate use of antimicrobials among public and health-care staff. The objective of our study was to determine the antimicrobial susceptibility of Staphylococcus aureus among children in a semi-closed geographic region with controlled antimicrobial use. The average hospital visit-based rate for antimicrobial drug prescription drastically decreased from 535 per 1,000 clinic visits before the intervention programs to 45-75 per 1,000 clinic visits after the intervention programs (P < 0.0001). We obtained 1,260 clinical isolates of S. aureus from 957 pediatric outpatients aged 0-15 years between 2002 and 2010 at Sado General Hospital. The prevalence of methicillin-resistant S. aureus (MRSA) in the final year of the study (2010, 7.9%) was significantly lower than that in the early period of the study (2003, 23.6%; P < 0.001). All tested S. aureus isolates were susceptible to trimethoprim/sulfamethoxazole, teicoplanin, linezolid, and vancomycin. The prevalence of gentamicin-resistant S. aureus in isolates from skin lesions was significantly higher than in isolates from other lesions (41.3% versus 28.5%; P < 0.05). In conclusion, prevalence of MRSA in children in our study population could be decreased by eliminating unnecessary antimicrobial drug prescriptions.
authors.affiliation: Department of Pediatrics, Sado General Hospital, Niigata 952-1209, Japan. ootsukataketo＠hotmail.com
authors.forename: Taketo
authors.initials: T
authors.lastname: Otsuka
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Yoshida
authors.forename: Kenichi
authors.initials: K
authors.lastname: Komiyama
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Hassan
authors.initials: H
authors.lastname: Zaraket
authors.forename: Minoru
authors.initials: M
authors.lastname: Okazaki
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D004358:Drug Therapy / Q000379:methods / Q000592:standards*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents