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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Staphylococcus aureus Infection in a Pediatric ICU: A Hospital Based Prospective Observational Study
Ishtiyaq Qadri1, Ishaq Malik1, Kaisar Ahmed1
1Department of Pediatrics, GB Pant Hospital, Srinagar, Jammu and Kashmir, India.
Insights
Staphylococcus aureus infections are common in pediatric ICUs, with high mortality rates, especially from MRSA. This study highlights the need for further investigation into bimodal age distribution for severe staph infections.
Area of Science:
- Infectious Diseases
- Pediatric Critical Care
- Epidemiology
Background:
- Staphylococcus aureus (SA) infections in pediatric intensive care units (PICUs) are linked to significant mortality and morbidity.
- Limited data exists on the epidemiology of SA infections within PICU settings.
- This study addresses the need for understanding the clinical and epidemiological characteristics of SA infections in PICU patients.
Purpose of the Study:
- To determine the clinicoepidemiological profile of children admitted to the ICU with Staphylococcus aureus infection.
- To analyze the outcomes associated with Staphylococcus aureus infections in a PICU setting.
- To investigate the incidence and characteristics of Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) in this population.
Main Methods:
- A prospective observational study conducted in a tertiary care hospital's PICU in northern India.
- Enrolled children with culture-proven Staphylococcus aureus infection; excluded those with suspected infection without positive cultures.
- Collected baseline characteristics, monitored clinical course, complications, and outcomes until discharge or death.
Main Results:
- Staphylococcus aureus infection was identified in 4.83% of 2,480 PICU admissions.
- Pneumonia (43.3%), septicaemia (20.8%), and bone/joint infections (15%) were the most common manifestations.
- Methicillin-resistant SA (MRSA) accounted for 35% of infections, with a higher mortality rate (20.8%) compared to MSSA.
Conclusions:
- Staphylococcus aureus infections and associated mortality are prevalent in the PICU.
- MRSA infections are more frequent in children with chronic conditions and are linked to increased mortality.
- A bimodal age distribution for severe staph infections was observed, warranting further research.
Introduction:
Admission to a pediatric intensive care unit (PICU) with a Staphylococcus aureus (SA) infection is associated with considerable mortality and morbidity. There is paucity of data about epidemiology of SA infection in a PICU. This study was aimed at elucidating the clinicoepidemiological profile and outcome of children admitted to ICU with S. aureus infection.
Methods:
This study was carried out in a PICU at a tertiary care hospital in northern India. Children admitted with culture positive S. aureus infection were enrolled in this study. Children suspected of having S. aureus infection on clinical grounds only without a positive culture were excluded from the study. Baseline characteristics of the subjects were recorded on admission and daily follow up maintained till death or discharge from PICU. The course during PICU stay, ensuing complication, and outcome was recorded.
Results:
There were 2,480 total admissions to the PICU during study period of one year, out of which 120 (4.83%) admissions had a culture proven S. aureus infection. Fifty-six (46.6%) were male and 64 (53.3%) were female. Most of the subjects fell in the age groups of 1-5 years and 10-15 years having 56 (46.6%) and 40 (33.3%) subjects, respectively. Pneumonia (43.3%), septicaemia (20.8), and bone/joint space infections (15%) were the three main clinical manifestations. Forty-two (35%) of specimens were reported as methicillin resistant. Incidence of methicillin resistant SA (MRSA) infection was 1.6 and that of methicillin sensitive SA (MSSA) 3.1 per 100 admissions to PICU. On sensitivity testing, none of the specimens was found to be vancomycin resistant. There were 240 total deaths in PICU during study period out of which 25 (10.4%) were observed from the study group. Mortality rate was 20.8%. Mortality was high in the MRSA group.
Conclusion:
The incidence of S. aureus infection and associated mortality is high in PICU. MRSA infection was more common in children admitted with chronic disease and is associated with higher mortality. Our study found a bimodal age distribution for serious staph infection, a finding that needs further evaluation.
How To Cite This Article:
Qadri I, Malik I, Ahmed K. Staphylococcus aureus Infection in A Pediatric ICU: A Hospital Based Prospective Observational Study. Indian J Crit Care Med 2019;23(5):210-212.
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