Clinical characteristics and epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in children with cystic fibrosis from a center with a high MRSA prevalence

Autor: John L. Carroll, Mary E. Stemper, Nada Harik, Maria Melguizo Castro, Gulnur Com, Xinyu Tang
Rok vydání: 2016
Předmět:
DNA
Bacterial
Male
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
Adolescent
Cystic Fibrosis
Genotype
Epidemiology
medicine.disease_cause
Staphylococcal infections
Polymerase Chain Reaction
Microbiology
03 medical and health sciences
0302 clinical medicine
Internal medicine
Prevalence
medicine
Humans
Pseudomonas Infections
030212 general & internal medicine
Child
Retrospective Studies
Coinfection
Pseudomonas aeruginosa
Transmission (medicine)
business.industry
Health Policy
Public Health
Environmental and Occupational Health
Clindamycin
Staphylococcal Infections
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
medicine.disease
Methicillin-resistant Staphylococcus aureus
United States
Electrophoresis
Gel
Pulsed-Field
Molecular Typing
Infectious Diseases
030228 respiratory system
Staphylococcus aureus
Child
Preschool
Female
business
medicine.drug
Zdroj: American Journal of Infection Control. 44:409-415
ISSN: 0196-6553
DOI: 10.1016/j.ajic.2015.10.015
Popis: Background We describe the clinical characteristics and epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in children with cystic fibrosis (CF) from the U.S. CF center with the highest MRSA prevalence. Methods Medical records of children with CF were retrospectively reviewed from 1997-2009. MRSA clinical isolates from 2007-2009 were analyzed by polymerase chain reaction and pulsed field gel electrophoresis. Results The prevalence of MRSA was 1% in 1997 and 49% in 2009. Fifty-five children (26%) had persistent MRSA infection. Sixty-eight percent of MRSA isolates were hospital-associated (HA) MRSA, of which 52% were pulsed-field type USA 100. Ninety-three percent of HA MRSA isolates were clindamycin resistant. Twelve children acquired MRSA before 1 year of age, 83% of whom were hospitalized prior to acquisition of MRSA. Ten of 11 sibling pairs carried indistinguishable MRSA strains. Children with persistent MRSA were hospitalized more often ( P = .01), required inhaled medications more frequently ( P = .01), and had higher rates of Pseudomonas aeruginosa coinfection ( P Conclusion MRSA prevalence in children with CF is increasing, and most children are infected with HA MRSA. Exposure to health care facilities and gastrointestinal surgeries may facilitate early acquisition of MRSA. Siblings carry indistinguishable MRSA strains, indicating household transmission of MRSA. Children with persistent MRSA had worse pulmonary morbidity. Coinfection with MRSA and P aeruginosa is likely associated with further increased pulmonary morbidity.
Databáze: OpenAIRE
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