title: Pediatric Staphylococcus aureus Infections: Impact of Methicillin Resistance at a Canadian Center.
abstract: OBJECTIVE
  Methicillin-resistant Staphylococcus aureus (MRSA) causes a wide spectrum of potentially serious infections in children. This study describes the evolving experience with S. aureus infections at a Canadian tertiary pediatric care center serving a wide geographic area.
  
  
  METHODS
  In this two-component study, a retrospective review of infection control databases for MRSA infection was conducted, along with a prospective component for 1 year during which all community-onset S. aureus infections were identified. Cases with methicillin resistance and susceptibility were compared.
  
  
  RESULTS
  Review of infection control database records showed 239 unique infections, with steady increases over time. Common pulsed-field gel electrophoresis types included Canadian MRSA-7 and Canadian MRSA-10. During the 1-year prospective component, 210 clinical infections were identified, with MRSA isolated in 41%. Patients with MRSA were significantly younger than those with methicillin-susceptible isolates (4.9 vs 7.7 years, P < 0.001). The most common presentations were soft tissue infections in the emergency department, with a degree of inappropriate antimicrobial use.
  
  
  CONCLUSIONS
  MRSA contributed to a significant proportion of S. aureus infections at a large Canadian tertiary care center. Ample opportunities exist to develop stewardship protocols, especially for the management of soft tissue infections in outpatients.
authors.affiliation: From the Section of Pediatric Infectious Diseases, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fanella
authors.affiliation: From the Section of Pediatric Infectious Diseases, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Embree
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002170:Canada; D002391:Catchment Area, Health; D002481:Cellulitis / Q000382:microbiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D004322:Drainage; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008350:Manitoba; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D012703:Serotyping; D018461:Soft Tissue Infections / Q000382:microbiology* / Q000628:therapy; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology* / Q000628:therapy; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents