title: Invasive community-acquired Staphylococcus aureus among pediatric population of Eastern Iran.
abstract: OBJECTIVE
  Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly reported worldwide. We aimed to determine the frequency of invasive CA-MRSA in children admitted to the pediatric wards of Imam Reza and Ghaem hospitals of Mashhad, Iran.
  
  
  METHODS
  In this retrospective study, data regarding S. aureus isolates from pediatric patients' sterile body sites (i.e. blood' joint, bone and lymph node aspiration) were retrieved in a time period from March 2006 to March 2012. Disc diffusion data was analyzed to determine the resistance pattern of the isolates, and differentiation between community-acquired and nosocomial S. aureus was done according to CDC guidelines.
  
  
  RESULTS
  Twenty three invasive community-acquired S. aureus isolates from sterile body sites were identified, of which seventeen (74%) were CA-MRSA. The CA-MRSA isolates showed high frequency of resistance to non-β-lactam antibiotics (71% to erythromycin' 53% to co-trimoxazole, 44% to gentamicin and 36% to ciprofloxacin).
  
  
  CONCLUSIONS
  In this study, the majority of invasive community-acquired S. aureus isolates were found to be CA-MRSA. Therefore, we recommend that primary treatment should be with antibiotics such as clindamycin, vancomycin, linezolid or daptomycin for any invasive infection suspected to be caused by S. aureus in these two hospitals.
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mohammadsaeed
authors.initials: M
authors.lastname: Sasan
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Donyadide
authors.affiliation: Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Emran
authors.initials: E
authors.lastname: Askari
authors.affiliation: Department of Microbiology, Central Laboratory, Imam Reza Teaching Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Naderi-Nasab
keywords: Staphylococcus aureus; child; community-acquired infections; methicillin resistance