Related Experiment Video
Updated: Jul 30, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Staphylococcus aureus infections among children receiving a solid organ transplant: clinical features, epidemiology,
J C McNeil1, F M Munoz, K G Hultén
1Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.
Insights
Staphylococcus aureus infections are a significant concern in pediatric solid organ transplant (SOT) recipients, often leading to graft rejection. Early post-transplant infections are particularly invasive and linked to methicillin-susceptible S. aureus (MSSA).
Area of Science:
- Pediatric Infectious Diseases
- Transplant Medicine
- Microbiology
Background:
- Staphylococcus aureus is a leading cause of healthcare-associated infections (HAIs) in the US.
- Pediatric solid organ transplant (SOT) recipients are uniquely vulnerable to HAIs due to immunosuppression and invasive procedures.
- Limited data exists on S. aureus infections in pediatric SOT patients.
Purpose of the Study:
- To describe the epidemiology of S. aureus infections in pediatric SOT recipients.
- To analyze antimicrobial susceptibility patterns of S. aureus isolates.
- To identify clinical features and outcomes of these infections.
Main Methods:
- Prospective surveillance database (2001-2012) at Texas Children's Hospital.
- Inclusion of patients with a history of SOT and S. aureus infection.
- Review of medical records and antibiotic susceptibility profiles, noting time since transplantation.
Main Results:
- 41 S. aureus infections occurred in 38 pediatric SOT recipients (highest incidence in heart recipients).
- Most common infections: skin-and-soft-tissue (66.1%) and bacteremia (15.3%).
- Antimicrobial resistance: methicillin (47.5%), clindamycin (16.9%), mupirocin (6.7%).
- Early infections (<1 month) were bacteremia (P=0.007) caused by MSSA.
- Late infections (>6 months) comprised 90.2% of cases.
- 16.9% of infections were associated with graft rejection.
Conclusions:
- S. aureus is a significant cause of morbidity in pediatric SOT recipients.
- While most infections occur late, early infections are more invasive and caused by MSSA.
- Awareness of S. aureus risks and potential for graft rejection is crucial for clinicians managing SOT patients.
Background:
Staphylococcus aureus is among the most common causes of healthcare-associated infection (HAI) in the United States. Patients who have received a solid organ transplant (SOT) represent a unique population for the acquisition of HAIs, given their preoperative organ failure, immunosuppression, and need for invasive procedures. However, limited literature is published on S. aureus infections among children with SOT. We describe the epidemiology, antimicrobial susceptibility, and clinical features of S. aureus infections among pediatric SOT recipients.
Design:
An ongoing prospective S. aureus surveillance database from 2001 to 2012 was searched for infections in patients with a history of SOT at Texas Children's Hospital. Medical records and antibiotic susceptibility profiles were reviewed; specific attention was applied to the time since transplantation to infection.
Results:
Out of the total of 696 transplants performed during the study period, 38 pediatric SOT recipients developed 41 S. aureus infections; the highest incidence of infection was among heart recipients. Overall, the most common infectious diagnoses were skin-and-soft-tissue infections (66.1%), followed by bacteremia (15.3%). Among isolates in SOT patients, 47.5%, 16.9%, and 6.7% were resistant to methicillin, clindamycin, or mupirocin, respectively. Three infections (7.3%) occurred in the early post-transplant period (<1 month), all of which were bacteremia (P = 0.007) and all caused by methicillin-susceptible S. aureus (MSSA). The majority of infections (90.2%) occurred in the late post-transplant period (>6 months). In 10 cases (16.9%), S. aureus infection was associated with graft rejection during the same admission.
Conclusions:
S. aureus represents an important cause of morbidity in pediatric SOT recipients. While the majority of infections occurred late after transplant (>6 months), those acquired in the early post-transplant period were more often invasive and caused by MSSA in our hospital. Physicians caring for SOT recipients should be aware of the risks posed by this pathogen and the potential concomitant morbidity including graft rejection.
Related Concept Videos
01:24Tissue Transplantation
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:29Staphylococcal Skin Infections
01:25Mechanism of Antibiotic Resistance in MRSA
01:25Clinical Significance of Antibiotic Resistance