title: Paediatric community-associated Staphylococcus aureus: a retrospective cohort study.
abstract: OBJECTIVE
  We aimed to characterise the demographic and clinical features of paediatric community-associated Staphylococcus aureus (CA-SA) infection. We aimed to identify factors associated with methicillin-resistant S.aureus (MRSA) infection evident at the point of care with the potential to guide antibiotic choice.
  
  
  METHODS
  A retrospective chart review in 2008 of CA-SA infections at the Children's Hospital at Westmead (CHW), a 300-bed tertiary paediatric hospital in western Sydney, Australia. We calculate rates of MRSA and perform univariate and multivariate analysis for predictors of MRSA.
  
  
  RESULTS
  Of 431 patients with CA-SA infections, 19.3% were MRSA. In univariate analysis, MRSA was predicted by age greater than 1 year, Aboriginal race, rural/regional residence, previous history of skin and soft tissue infection (SSTI) or a family history of SSTI, at least 48 h of antibiotics active against methicillin-sensitive S.aureus (MSSA), invasive infection and abscess formation. In a multivariate analysis factors that independently predicted MRSA in the entire cohort, and in the non-invasive subgroup included abscess formation, a family history of staphylococcal infection or SSTI, Aboriginal ethnicity, at least 48 h of anti-MSSA antibiotics at presentation, presentation during spring and age greater than 1 year.
  
  
  CONCLUSIONS
  One fifth of CA-SA infections at our tertiary paediatric hospital in 2008 were MRSA. Several clinical and demographic factors evident at the point of care were highly significant predictors of CA-MRSA infection.
authors.affiliation: Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Philip N
authors.initials: PN
authors.lastname: Britton
authors.forename: David N
authors.initials: DN
authors.lastname: Andresen
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D015999:Multivariate Analysis; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents
keywords: Staphylococcus aureus; general paediatrics; infectious diseases; skin and soft tissue infection