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Paediatric community-associated Staphylococcus aureus: A retrospective cohort study

Authors

  • Philip N Britton,

    Corresponding author
    1. Discipline of Paediatrics and Child Health, The University of Sydney, Sydney, New South Wales, Australia
    • Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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  • David N Andresen

    1. Department of Microbiology and Infectious Diseases, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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  • Conflict of interest: The authors report no relevant conflicts of interest nor have they received any relevant financial support.

Correspondence: Dr Philip N Britton, Department of Infectious Diseases and Microbiology, Sydney Children's Hospital – Westmead, Cnr Hawkesbury Rd and Hainsworth St, Westmead, NSW 2145, Australia. Fax: 0612 9845 3291; email: philip.britton@health.nsw.gov.au

Abstract

Aim

We aimed to characterise the demographic and clinical features of paediatric community-associated Staphylococcus aureus (CA-SA) infection. We aimed to identify factors associated with methicillin-resistant S. aureus (MRSA) infection evident at the point of care with the potential to guide antibiotic choice.

Methods

A retrospective chart review in 2008 of CA-SA infections at the Children's Hospital at Westmead (CHW), a 300-bed tertiary paediatric hospital in western Sydney, Australia. We calculate rates of MRSA and perform univariate and multivariate analysis for predictors of MRSA.

Results

Of 431 patients with CA-SA infections, 19.3% were MRSA. In univariate analysis, MRSA was predicted by age greater than 1 year, Aboriginal race, rural/regional residence, previous history of skin and soft tissue infection (SSTI) or a family history of SSTI, at least 48 h of antibiotics active against methicillin-sensitive S. aureus (MSSA), invasive infection and abscess formation. In a multivariate analysis factors that independently predicted MRSA in the entire cohort, and in the non-invasive subgroup included abscess formation, a family history of staphylococcal infection or SSTI, Aboriginal ethnicity, at least 48 h of anti-MSSA antibiotics at presentation, presentation during spring and age greater than 1 year.

Conclusions

One fifth of CA-SA infections at our tertiary paediatric hospital in 2008 were MRSA. Several clinical and demographic factors evident at the point of care were highly significant predictors of CA-MRSA infection.

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