Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics

Abstract

Background: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) has changed in recent years. The present article is intended to establish differences between clinical, laboratory and imaging findings and outcomes of MSSA and MRSA infections, as well as among subgroups of infection such as skin and soft tissue infection, osteoarticular, bacteremia or pneumonia in a pediatric population from Bogota, Colombia. Methods: Retrospective cohort study using clinical records of patients under 18 years of age treated at the participating centers in Bogota, Colombia, between 2014 and 2018. The first positive S. aureus culture was studied. MSSA and MRSA were compared. The χ 2 test, Fisher exact test, and Kruskal-Wallis test were calculated, and the statistical significance was presented using the difference and its 95% CI. Results: Five hundred fifty-one patients were included; 211 (38%) corresponded to MRSA and 340 (62%) to MSSA for a total of 703 cultures. A significantly higher probability of having an MSSA infection than MRSA was found in patients with previous heart disease (3.3% vs. 0.5%), neurologic disease (5.9% vs. 2.5%), recent major surgeries (11% vs. 5%) or who has an implanted device (11% vs. 4%). In contrast, in severe MRSA infections (bacteremia, osteoarticular infections and pneumonia), a higher rate of complications was seen (admission to the pediatric intensive care unit, mechanical ventilation and vasoactive support), and in osteoarticular MRSA, more than 1 surgery per case was seen (89% vs. 61%). Laboratory results and mortality were similar. Conclusions: MRSA was associated with a more severe course in bacteremia, osteoarticular infections and pneumonia. Some classical risk factors associated with MRSA infections were found to be related to MSSA. In general, with the exception of skin and soft tissue infection, there was an increased risk of pediatric intensive care unit admission and mechanical and inotropic support with MRSA in a pediatric population.

Staphylococcus aureus causes aberrant epidermal lipid composition and skin barrier dysfunction

“…In our study, nearly 43% of S. aureus isolates from the lesional skin samples of AD pediatric patients were MRSA. This is consistent with previous studies that reported 10%–42% MRSA isolates among S. aureus ‐positive AD skin cultures 8,35,36 . In AD skin cultures, MRSA strains are on the rise and are more virulent than MSSA 37–39 .…”

“…This is consistent with previous studies that reported 10%-42% MRSA isolates among S. aureus-positive AD skin cultures. 8,35,36 In AD skin cultures, F I G U R E 6 Expression of ELOVL3 and ELOVL4 in human primary keratinocytes stimulated with MRSA and neutralizing antibodies. HEKs were differentiated and preincubated with isotype control antibodies or neutralizing antibodies against TNFα (0.1 μg/ml), IL-1β (10 ng/ ml), IL-36γ (1.0 μg/ml), IL-6 (0.1 μg/ml), and IL-33 (1.0 μg/ml) separately or in combination (all same concentrations) for MRSA strains are on the rise and are more virulent than MSSA.…”

Correlation between the results of cultures and the molecular BIOFIRE® joint infection panel in a cohort of pediatric patients with bone and joint infections in Bogotá, Colombia

“…and S. aureus and another with S. aureus and Streptococcus pyogenes ). The prevalence of methicillin-resistant S. aureus was 52.3%, slightly higher than that reported in other studies in Colombia ( 14 , 15 ). The correlation between the phenotypic profile and the detection of the mecA gene was 100%.…”

Efficacy of Vaporized Hydrogen Peroxide Combined with Silver Ions against Multidrug-Resistant Gram-Negative and Gram-Positive Clinical Isolates

“…Additionally, one of the MRSA strains was resistant to macrolides, specifically to erythromycin ( Table 2 ). The MRSA strains included in this study showed resistance profiles similar to those of clinical isolates circulating in hospital settings in Colombia [ 30 , 31 ]. S. aureus , including MRSA strains, has been reported to be one of the leading causes of nosocomial infections worldwide, especially among patients in surgery, undergoing hemodialysis, and in ICU units, because of the long-term use of venous and urinary catheters [ 32 , 33 , 34 ].…”