title: Community-acquired Staphylococcus aureus bacteremia in children: a cohort study for 2010-2014.
abstract: BACKGROUND
  Community-acquired methicillin-resistant Staphylococcus aureus infections are a common, serious problem in pediatrics.
  
  
  OBJECTIVE
  To describe antibiotic resistance in community-acquired Staphylococcus aureus (SA) bacteremias. To compare the characteristics of SA bacteremias in terms of methicillin resistance.
  
  
  METHODS
  Prospective cohort enrolled between January 2010 and December 2014. Inclusion criteria: infants and children between 30 days old and 16 years old hospitalized at the Hospital de Pediatria J. P. Garrahan due to community-acquired infections with SA growth identification in blood cultures. Exclusion criteria: having a history of recent hospitalization, attending a health care facility, living in a closed community, or having a venous catheter. Microbiological, demographic, and clinical characteristics were compared in terms of methicillin susceptibility. Statistical analysis: Stata10.
  
  
  RESULTS
  A total of 208 children were included; boys: 141 (68%). Their median age was 60 months old (interquartile range: 29-130). Thirty-four patients (16%) had an underlying disease. Methicillin-resistant Staphylococcus aureus was identified in 136 children (65%). The rate of resistance to clindamycin was 9%. Significant statistical differences were observed in the rate of underlying disease, persistent bacteremia, sepsis at the time of admission, secondary source of infection, admission to the intensive care unit, and surgery requirement. Twelve patients (6%) died; community-acquired methicillin-resistant Staphylococcus aureus was identified in all of them.
  
  
  CONCLUSIONS
  In the studied cohort, methicillin-resistant S taphylococcus aureus was predominant. The rate of resistance to clindamycin was 9%. Community-acquired methicillin-resistant Staphylococcus aureus infections prevailed among healthy children. Among patients with methicillin-resistant Staphylococcus aureus infections there was a higher rate of persistent bacteremia, admission to the ICU and surgery.
authors.affiliation: Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina. guaperez@hotmail.com.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Pérez
authors.affiliation: Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Soledad
authors.initials: S
authors.lastname: Martiren
authors.affiliation: Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Reijtman
authors.affiliation: Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Romina
authors.initials: R
authors.lastname: Romero
authors.affiliation: Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Mastroianni
authors.affiliation: Servicio de Microbiología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Lidia
authors.initials: L
authors.lastname: Casimir
authors.affiliation: Servicio de Control Epidemiológico e Infectología, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Rosa
authors.initials: R
authors.lastname: Bologna
mesh_terms: D016470:Bacteremia / Q000188:drug therapy* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013997:Time Factors
keywords: Community-acquired infections; Methicillin resistance; Staphylococcus aureus