Methicillin-resistant Staphylococcus aureus empyema in children.

Area of Science:

• Infectious Diseases
• Pulmonology
• Critical Care Medicine

Background:

• Staphylococcal empyema presents a significant treatment challenge.
• Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common pathogen in empyema.
• Outcomes for MRSA empyema are often poor with standard therapies.

Purpose of the Study:

• To evaluate treatment outcomes for staphylococcal empyema caused by MRSA.
• To identify effective antimicrobial strategies for MRSA empyema.
• To inform initial treatment choices in MRSA-endemic regions.

Main Methods:

• Retrospective review of 20 patients with MRSA empyema over 14 years.
• Analysis of treatment regimens including antibiotics (penicillinase-resistant penicillin, cephalosporin, carbapenem, aminoglycoside) and drainage procedures.
• Comparison of outcomes between community-acquired and hospital-acquired infections.

Main Results:

• Seven of 20 patients died, with 6 deaths in bacteremic cases.
• Standard antibiotic and drainage treatments were often refractory.
• One patient with bacteremic MRSA empyema achieved cure with vancomycin.

Conclusions:

• Staphylococcal empyema due to MRSA has high mortality.
• Vancomycin may be a crucial first-line agent for MRSA empyema in endemic areas.
• Prompt administration of appropriate antibiotics, like vancomycin, is critical pending susceptibility results.