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  • Title: [Community onset of methicillin resistant Staphylococcus aureus infections in previously healthy or health care-associated children in Argentina].
    Author: Paganini H, Della MP, Muller B, Ezcurra G, Uranga M, Aguirre C, Kamiya M, Ensinck G, Miranda MR, Ciriaci C, Hernández C, Casimir L, Rial MJ, Schenonne N, Ronchi E, Rodríguez Mdel C, Aprile F, De Ricco C, Saito V, Vrátnica C, Pons L, Ernst A, Morinigo S, Toffoli M, Bosque C, Monzani V, Mónaco A, Pinheiro JL, López Mdel P, Maninno L, Sarkis C.
    Journal: Rev Chilena Infectol; 2009 Oct; 26(5):406-12. PubMed ID: 19915748.
    Abstract:
    INTRODUCTION: Community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) are prevalent in several countries of the world. These infections seem to differ clinically from those occurring within the health care system (HCS-MRSA). OBJECTIVE: To compare clinical characteristics of infections by CA-MRSA and HCA-MRSA in the same community. MATERIAL AND METHODS: Prospective, multicentric and comparative study. Children with clinically and microbiologically documented CA-MRSA were included. RESULTS: Between 11/2006 and 11/2007, 840 infections caused by S. aureus were diagnosed. Of them 582 (68%) were community-acquired. Among these 356 (61%) were CA-MRSA. In this group, 75 (21%) were HCA-MRSA and 281 (79%) CA-MRSA. The median age was 36 months (range: 1-201). Chronic skin disease (13) and chronic disease of CNS (9) were the underlying disease predominant. Children with CA-MRSA had more frequency of previous antibiotic treatment (63 vs 34%) and previous medical consult (76 vs 52%), invasive procedures (31 vs 8%), surgery (15 vs 0.3%) and fever (94 vs 74%) (p = < 05). Children with CA-MRSA had subcutaneous abscesses (34 vs 15%) (p = < .05) more frequently. Bacteremia and sepsis rate was similar in both groups (21 vs 18%) and 17 vs 11%) respectively) (p = NS). Antibiotic resistance was more frequent in children with HCA-MRSA: Rifampin (7 vs 1%), trimethoprim-sulphametoxazole (7 vs 1%) and clindamycin (25 vs 9%) (p = < .05). Four children (5%) with HCA-MRSA infections died and 3 (1%) mCA-MRSA group (p = .05). CONCLUSION: Children with HCA-MRSA infections more frequent antibiotic resistance than CA-MRSA should be reconsider the empiric antibiotic treatment of community-acquired infections in children in our area.
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