title: Disseminated staphylococcal disease in healthy children-experience from two tertiary care hospitals of West Bengal.
abstract: OBJECTIVE
  To assess the etiology, precipitating factors, treatment and outcome of disseminated staphylococcal disease (DSD) in healthy immunocompetent children.
  
  
  METHODS
  This hospital based observational prospective study was conducted in two tertiary care hospitals of West Bengal, India during the period of March, 2011 through February, 2012. Inclusion criteria were 1) children between 1 and 12 y and 2) clinical features DSD characterized by i) involvement of at least two distant organs with presence of gram positive cocci in clusters and/or growth of Staphylococcus aureus from at least one normally sterile body fluid, ii) fever, persistent bacteremia despite antibiotics and focal involvement of two or more separate tissue sites (skin, bone, joint, kidney, lung, liver, heart).
  
  
  RESULTS
  Thirty six cases fulfilled the criteria of DSD with mean age in years 6.03 ± 3.04 (range 1-12). The age group of 5-12 y was found to be more vulnerable (p < 0.001). Septic arthritis following accidental blunt closed trauma, was the significant precipitating factor for DSD in this age group (p = 0.031). Methicillin resistant Staphylococcus aureus (MRSA) was the causative agent in all the cases. Vancomycin resistant Staphylococcus aureus (VRSA) was detected in 88.9 % of cases. All cases were sensitive to linezolid. No significant side effects were observed with 28 d of linezolid therapy.
  
  
  CONCLUSIONS
  DSD is more common in 5-12 y age group. Trauma is a significant precipitating factor for DSD in this age group. Linezolid may be considered as the first line drug in DSD with MRSA.
authors: Department of Pediatrics, North Bengal Medical College and Hospital, Sushrutanagar, Darjeeling, West Bengal, India.
authors: Kalyanbrata
authors: K
authors: Mandal
authors: Abhishek
authors: A
authors: Roy
authors: Sandip
authors: S
authors: Sen
authors: Toshibananda
authors: T
authors: Bag
authors: Nitish
authors: N
authors: Kumar
authors: Sumana
authors: S
authors: Moitra
mesh_terms: D000081:Acetamides / Q000627:therapeutic use; D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007121:Immunocompetence; D000069349:Linezolid; D008279:Magnetic Resonance Imaging; D008297:Male; D023303:Oxazolidinones / Q000627:therapeutic use; D012307:Risk Factors; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000081:Acetamides; D000890:Anti-Infective Agents; D023303:Oxazolidinones; D000069349:Linezolid
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