Skip to main content Accessibility help
×
×
Home

Epidemiology of Methicillin-Resistant Staphylococcus aureus at a Children's Hospital

  • Andrew L. Campbell (a1), Kristina A. Bryant (a1), Beth Stover (a1) and Gary S. Marshall (a1)
Abstract
Objective:

To describe the relative contribution of and risk factors for both community-acquired and nosocomial methicillin-resistant Staphylococcus aureus (MRSA) infections.

Design:

Retrospective cohort study.

Setting:

270-bed, tertiary-care children's hospital.

Participants:

All MRSA-infected children from whom MRSA was recovered between October 1, 1999, and September 30, 2001.

Methods:

Demographic, clinical, and risk factor data were abstracted from medical records. Categorical variables were analyzed using the chi-square or Fisher's exact test and continuous variables were analyzed using the Mann-Whitney test.

Results:

Of the 62 patients with new MRSA infection, 37 had community-acquired MRSA and 25 had nosocomial MRSA. Most community-acquired MRSA infections were of the skin and soft tissue, the middle ear, and the lower respiratory tract. Nosocomial MRSA infections occurred in the lower respiratory tract, the skin and soft tissue, and the blood. Risk factors for infection, including underlying medical illness, prior hospitalization, and prior surgery, were similar for patients with community-acquired MRSA and nosocomial MRSA. History of central venous catheterization and previous endotracheal intubation was more common in patients with nosocomial MRSA. Only 3 patients with community-acquired MRSA had no identifiable risk factor other than recent antibiotic use. Resistance for clindamycin, erythromycin, and levofloxacin was similar between strains of community-acquired MRSA and nosocomial MRSA.

Conclusions:

Similarities in patient risk factors and resistance patterns of isolates of both community-acquired and nosocomial MRSA suggest healthcare acquisition of most MRSA. Thus, classifying MRSA as either community acquired or nosocomial underestimates the amount of healthcare-associated MRSA.

Copyright
Corresponding author
Kosair Charities Fellow, Pediatric Infectious Diseases, Division of Pediatric Infectious Diseases, University of Louisville, 571 S. Floyd St., Suite 321, Louisville, KY 40204
References
Hide All
1.Barrett, FF, McGehee, RF, Finland, M. Methicillin-resistant Staphylococcus aureus at Boston City Hospital. N Engl J Med 1968;279:441448.
2.Layton, MC, Hierholzer, WJ, Patterson, JE. The evolving epidemiology of methicillin-resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995;16:1217.
3.Rathore, MH, Kline, MW. Community-acquired methicillin-resistant Staphylococcus aureus infections in children. Pediatr Infect Dis J 1989;8:645647.
4.Moreno, F, Crisp, C, Jorgensen, JH, Patterson, JE. Staphylococcus aureus as a community organism. Clin Infect Dis 1995;21:13081312.
5.Chambers, HEThe changing epidemiology of Staphylococcus aureus? Emerg Infect Dis 2001;7:178182.
6.Herold, BC, Immergluck, LC, Maranan, MC, et al.Community-acquired methicillin-resistant Staphylococcus aureus infections in children with no predisposing risk. JAMA 1998;279:593598.
7.Gorak, EJ, Yamada, SM, Brown, JD. Community-acquired methicillin-resistant Staphylococcus aureus in hospitalized adults and children without known risk factors. Clin Infect Dis 1999;29:797800.
8.Suggs, AH, Maranan, MC, Boyle-Vavra, S, Daum, R. Methicillin-resistant and borderline methicillin-resistant asymptomatic Staphylococcus aureus colonization in children without identifiable risk factors. Pediatr Infect Dis J 1999;18:410414.
9.Frank, AL, Marcinak, JF, Mangat, PD, Schreckenberger, PC. Community-acquired and clindamycin-susceptible methicillin-resistant Staphylococcus aureus in children. Pediatr Infect Dis J 1999;18:9931000.
10.Frank, AL, Marcinak, JF, Mangat, PD, Schreckenberger, PC. Increase in community-acquired methicillin-resistant Staphylococcus aureus in children. Clin Infect Dis 1999;29:935936.
11.Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin-resistant Staphylococcus aureus: Minnesota and North Dakota, 1997-1999. MMWR 1999;48:707710.
12.Fergie, JE, Purcell, K. Community-acquired methicillin-resistant Staphylococcus aureus infections in South Texas children. Pediatr Infect Dis J 2001;20:860863.
13.Daum, RS. Community-acquired methicillin-resistant Staphylococcus aureus infections. Pediatr Infect Dis J 1998;17:745746.
14.Hussain, FM, Boyle-Vavra, S, Daum, RS. Community-acquired methicillin-resistant Staphylococcus aureus colonization in healthy children attending an outpatient clinic. Pediatr Infect Dis J 2001;20:763767.
15.Naimi, TS, LeDell, KH, Boxrud, DJ, et al.Epidemiology and clonality of community-acquired methicillin-resistant Staphylococcus aureus in Minnesota, 1996-1998. Clin Infect Dis 2001;33:990996.
16.Groom, AV, Wolsey, DH, Naimi, TS, et al.Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. JAMA 2001;286:12011205.
17.Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128140.
18.National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Disk Susceptibility Tests, Approved Standard, 6th ed. Wayne, PA: National Committee for Clinical Laboratory Standards; 1997.
19.Hageman, J, Como-Sabetti, K, Rego, V, et al.A multistate study of the epidemiology of community-onset methicillin-resistant Staphylococcus aureus. Presented at the 40th Annual Meeting of the Infectious Diseases Society of America; October 24-27, 2002; Chicago, IL. Abstract 121.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed