Paediatric community-associated Staphylococcus aureus: a retrospective cohort study.

Area of Science:

• Infectious Diseases
• Paediatric Medicine
• Microbiology

Background:

• Community-associated Staphylococcus aureus (CA-SA) is a significant pathogen in children.
• Methicillin-resistant S. aureus (MRSA) is an increasing concern in paediatric infections.
• Understanding predictors of MRSA can guide clinical management and antibiotic selection.

Purpose of the Study:

• To characterize the demographic and clinical features of paediatric CA-SA infections.
• To identify factors predicting MRSA at the point of care in children.
• To inform antibiotic choice for CA-SA infections.

Main Methods:

• Retrospective chart review of 431 paediatric CA-SA infections at a tertiary hospital in 2008.
• Calculation of MRSA rates.
• Univariate and multivariate analyses to identify predictors of MRSA.

Main Results:

• 19.3% of CA-SA infections were MRSA.
• Predictors of MRSA included age >1 year, Aboriginal ethnicity, rural residence, history of skin/soft tissue infection (SSTI), prior antibiotics, invasive infection, and abscess formation.
• Independent predictors in multivariate analysis included abscess, family history of staphylococcal infection/SSTI, Aboriginal ethnicity, prior anti-MSSA antibiotics, spring season, and age >1 year.

Conclusions:

• Approximately one-fifth of paediatric CA-SA infections in 2008 were MRSA.
• Several clinical and demographic factors are significant predictors of CA-MRSA infection at presentation.
• These findings can help guide initial antibiotic management for paediatric CA-SA.