title: Changing Susceptibility of Staphylococcus aureus in a US Pediatric Population.
abstract: Staphylococcus aureus is a major cause of infection in both adult and pediatric populations. After several decades of increasing prevalence, the proportion of S aureus infections due to methicillin-resistant S aureus has been reported to be in decline in adults. Data for similar changes in pediatric populations are limited.
  
  
  
  Evaluation of S aureus susceptibility data for pediatric patients receiving care in the US Military Health System was performed. Microbiology and demographic data were collected for years 2005 through 2014. Trends in antibiotic susceptibility results were evaluated. Clinical and demographic characteristics were explored to assess for association with antibiotic susceptibilities.
  
  
  
  In this study, 41 745 S aureus isolates from 39 207 pediatric patients were included. An overall increase in susceptibility of isolates to oxacillin was noted over this 10-year period; with over 60% of isolates oxacillin-susceptible in 2014. S aureus susceptibility to clindamycin declined over the study period; notably methicillin-susceptible S aureus susceptibility to clindamycin declined from 90% to 83% (P < .0001). Differences in oxacillin susceptibility between US regions decreased over time.
  
  
  
  Similar to recent trends seen in adults, the proportion of pediatric S aureus infections secondary to methicillin-resistant S aureus appear to be decreasing, as is variability in US geographical resistance rates. Increasing clindamycin resistance among methicillin-susceptible S aureus should raise caution in the use of empirical clindamycin in presumed S aureus infection. Clinicians should be aware of regional susceptibility patterns when choosing empirical regimens.
authors.affiliation: Department of Pediatrics, San Antonio Military Medical Center, Fort Sam Houston, Texas; deena.e.sutter.mil@mail.mil.
authors.forename: Deena E
authors.initials: DE
authors.lastname: Sutter
authors.affiliation: EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia;
authors.forename: Emma
authors.initials: E
authors.lastname: Milburn
authors.affiliation: EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia;
authors.forename: Uzo
authors.initials: U
authors.lastname: Chukwuma
authors.affiliation: Communicable Disease Branch North Carolina, Department of Health and Human Services, Raleigh, North Carolina; and.
authors.forename: Nicole
authors.initials: N
authors.lastname: Dzialowy
authors.affiliation: EpiData Center Department Navy and Marine Corps Public Health Center, Portsmouth, Virginia;
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Maranich
authors.affiliation: Department of Medicine, University of Texas Health Sciences Center, San Antonio, Texas.
authors.forename: Duane R
authors.initials: DR
authors.lastname: Hospenthal
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002981:Clindamycin / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008712:Methicillin / Q000494:pharmacology / Q000627:therapeutic use; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010068:Oxacillin / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D002981:Clindamycin; D008712:Methicillin; D010068:Oxacillin