title: Methicillin-resistant Staphylococcus aureus causes both community-associated and health care-associated infections in children at the Hospital Universitario de Santander.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infection in the pediatric population. Initially, MRSA was restricted to hospitals; however, outbreaks in the community among people without health care-related risk factors have been reported worldwide. Currently, MRSA is a frequent cause of both hospital and community-associated infections.
  
  
  OBJECTIVE
  To describe the relationships between the molecular characteristics of MRSA isolates (staphylococcal cassette chromosome mec (SCCmec) type and Panton-Valentine leukocidin (PVL) carriage) and the characteristics of infection (the origin and localization of infection) in pediatric patients at the Hospital Universitario de Santander in Bucaramanga, Colombia.
  
  
  METHODS
  A total of 43 MRSA isolates were obtained from hospitalized pediatric patients. SCCmec typing (I-V), SCCmec IV subtyping and PVL carriage were determined and related to the clinical characteristics.
  
  
  RESULTS
  Among the MRSA isolates studied, SCCmec IVc was present in 77%, followed by 16% for SCCmec I and 2% for SCCmec IVa. Two isolates were not typeable (NT). PVL genes were carried by 88% of the MRSA isolates, including the SCCmec IVc/IVa and SCCmec I isolates. SCCmec IV caused both community-acquired infection (CAI) (47%) and nosocomial infection (HAI) (53%). SCCmec IV, PVL-positive MRSA was associated with both CAI (47%) and HAI (53%) and caused mostly SSTI and osteoarticular infection.
  
  
  CONCLUSIONS
  These findings suggest that the presence of community-associated MRSA (CA-MRSA) (SCCmec IV and PVL positive) causes both health care-associated infection (HCAI) and nosocomial infection (HAI) in pediatric patients in Colombia.
authors: Grupo de Inmunología y Epidemiología Molecular, Facultad de Salud, Universidad Industrial de Santander.
authors: Mayra Alejandra
authors: MA
authors: Machuca
authors: Grupo de Inmunología y Epidemiología Molecular, Facultad de Salud, Universidad Industrial de Santander.
authors: Clara Isabel
authors: CI
authors: González
authors: Grupo PAIDOS, Facultad de Salud, Universidad Industrial de Santander.
authors: Luis Miguel
authors: LM
authors: Sosa
mesh_terms: D000293:Adolescent; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial; D005098:Exotoxins / Q000235:genetics; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007956:Leukocidins / Q000235:genetics; D008297:Male; D016106:Methicillin Resistance / Q000235:genetics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin