Community-acquired methicillin-resistant staphylococcus aureus in children with no identified predisposing risk

Betsy Herold, Lilly C. Immergluck, Melinda C. Maranan, Diane S. Lauderdale, Ryan E. Gaskin, Susan Boyle-Vavra, Cindy D. Leitch, Robert S. Daum

Research output: Contribution to journalArticle

1198 Citations (Scopus)

Abstract

Context.-Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. Objectives.-To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Design.-Retrospective review of medical records. Patients.-Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995). Setting.-The University of Chicago Children's Hospital. Main Outcome Measures.-Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease. Results.-The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100 000 admissions in 1988-1990 to 259 per 100 000 admissions in 1993- 1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children Without an identified risk (P=.02). Conclusions.- These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.

Original languageEnglish (US)
Pages (from-to)593-598
Number of pages6
JournalJournal of the American Medical Association
Volume279
Issue number8
DOIs
StatePublished - Feb 25 1998
Externally publishedYes

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Methicillin-Resistant Staphylococcus aureus
Hospitalized Child
Infection
Methicillin
Medical Records
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

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Community-acquired methicillin-resistant staphylococcus aureus in children with no identified predisposing risk. / Herold, Betsy; Immergluck, Lilly C.; Maranan, Melinda C.; Lauderdale, Diane S.; Gaskin, Ryan E.; Boyle-Vavra, Susan; Leitch, Cindy D.; Daum, Robert S.

In: Journal of the American Medical Association, Vol. 279, No. 8, 25.02.1998, p. 593-598.

Research output: Contribution to journalArticle

Herold, B, Immergluck, LC, Maranan, MC, Lauderdale, DS, Gaskin, RE, Boyle-Vavra, S, Leitch, CD & Daum, RS 1998, 'Community-acquired methicillin-resistant staphylococcus aureus in children with no identified predisposing risk', Journal of the American Medical Association, vol. 279, no. 8, pp. 593-598. https://doi.org/10.1001/jama.279.8.593
Herold, Betsy ; Immergluck, Lilly C. ; Maranan, Melinda C. ; Lauderdale, Diane S. ; Gaskin, Ryan E. ; Boyle-Vavra, Susan ; Leitch, Cindy D. ; Daum, Robert S. / Community-acquired methicillin-resistant staphylococcus aureus in children with no identified predisposing risk. In: Journal of the American Medical Association. 1998 ; Vol. 279, No. 8. pp. 593-598.
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abstract = "Context.-Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. Objectives.-To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Design.-Retrospective review of medical records. Patients.-Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995). Setting.-The University of Chicago Children's Hospital. Main Outcome Measures.-Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease. Results.-The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100 000 admissions in 1988-1990 to 259 per 100 000 admissions in 1993- 1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70{\%}) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24{\%}) of 25 isolates obtained from children Without an identified risk (P=.02). Conclusions.- These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.",
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AU - Maranan, Melinda C.

AU - Lauderdale, Diane S.

AU - Gaskin, Ryan E.

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AU - Leitch, Cindy D.

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N2 - Context.-Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. Objectives.-To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Design.-Retrospective review of medical records. Patients.-Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995). Setting.-The University of Chicago Children's Hospital. Main Outcome Measures.-Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease. Results.-The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100 000 admissions in 1988-1990 to 259 per 100 000 admissions in 1993- 1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children Without an identified risk (P=.02). Conclusions.- These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.

AB - Context.-Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in children have occurred primarily in individuals with recognized predisposing risks. Community-acquired MRSA infections in the absence of identified risk factors have been reported infrequently. Objectives.-To determine whether community-acquired MRSA infections in children with no identified predisposing risks are increasing and to define the spectrum of disease associated with MRSA isolation. Design.-Retrospective review of medical records. Patients.-Hospitalized children with S aureus isolated between August 1988 and July 1990 (1988-1990) and between August 1993 and July 1995 (1993-1995). Setting.-The University of Chicago Children's Hospital. Main Outcome Measures.-Prevalence of community-acquired MRSA over time, infecting vs colonizing isolates, and risk factors for disease. Results.-The number of children hospitalized with community-acquired MRSA disease increased from 8 in 1988-1990 to 35 in 1993-1995. Moreover, the prevalence of community-acquired MRSA without identified risk increased from 10 per 100 000 admissions in 1988-1990 to 259 per 100 000 admissions in 1993- 1995 (P<.001), and a greater proportion of isolates produced clinical infection. The clinical syndromes associated with MRSA in children without identified risk were similar to those associated with community-acquired methicillin-susceptible S aureus. Notably, 7 (70%) of 10 community-acquired MRSA isolates obtained from children with an identified risk were nonsusceptible to at least 2 drugs, compared with only 6 (24%) of 25 isolates obtained from children Without an identified risk (P=.02). Conclusions.- These findings demonstrate that the prevalence of community-acquired MRSA among children without identified risk factors is increasing.

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