Department of Healthcare-Associated Infections & Antimicrobial Resistance, HPA Centre for Infections, London NW9 5EQ, UK.
Arch Dis Child. 2010 Oct;95(10):781-5. doi: 10.1136/adc.2010.162537. Epub 2010 Jun 1.
To determine the incidence and demographic features of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in children in the UK and Ireland and to characterise MRSA isolated from cases.
Prospective surveillance study.
Children aged <16 years hospitalised with bacteraemia due to MRSA.
Cases were ascertained by active surveillance involving paediatricians reporting to the British Paediatric Surveillance Unit and by routine laboratory surveillance. Patient characteristics were obtained using questionnaires sent to reporting paediatricians. MRSA isolates were characterised using molecular and phenotypic techniques including antimicrobial susceptibility testing.
265 episodes of MRSA bacteraemia were ascertained, involving 252 children. The overall incidence rate was 1.1 per 100 000 child population per year (95% CI 0.9 to 1.2): 61% of the children were aged <1 year (a rate of 9.7 cases per 100 000 population per year (95% CI 8.2 to 11.4)) and 35% were <1 month. Clinical data were obtained from 115 cases. The clinical presentation varied, with fever present in only 16% of neonates compared with 72% of older children. A history of invasive procedure was common, with 32% having had intravascular lines and 13% having undergone surgery. 62% of patients for whom data were available were receiving high-dependency care (46% in SCBU/NICU and 16% in PICU). Of 93 MRSA isolates studied, 73% belonged to epidemic strains widely associated with nosocomial infection in the UK and Ireland.
MRSA bacteraemia in children was relatively uncommon and was predominantly seen in very young children, often those receiving neonatal or paediatric intensive care. Bacteraemia predominantly involved well-documented epidemic strains of MRSA associated with nosocomial infection.
确定英国和爱尔兰儿童耐甲氧西林金黄色葡萄球菌（MRSA）菌血症的发病率和人口统计学特征，并对从病例中分离出的 MRSA 进行特征描述。
前瞻性监测研究。
因 MRSA 菌血症住院的年龄<16 岁的儿童。
通过涉及向英国儿科监测单位报告的儿科医生的主动监测以及通过常规实验室监测来确定病例。使用发送给报告儿科医生的问卷获取患者特征。使用分子和表型技术（包括抗生素敏感性测试）对 MRSA 分离株进行特征描述。
确定了 265 例 MRSA 菌血症病例，涉及 252 名儿童。总体发病率为每年每 10 万儿童人口 1.1 例（95%CI0.9 至 1.2）：61%的儿童年龄<1 岁（发病率为每年每 10 万人口 9.7 例（95%CI8.2 至 11.4）），35%的儿童年龄<1 个月。从 115 例病例中获得了临床数据。临床表现各不相同，只有 16%的新生儿发热，而 72%的大龄儿童发热。有创性操作史很常见，有 32%的患儿有血管内导管，13%的患儿接受了手术。在可获得数据的 62%的患者中，正在接受高依赖护理（46%在 SCBU/NICU，16%在 PICU）。在研究的 93 株 MRSA 中，73%属于与英国和爱尔兰医院感染广泛相关的流行株。
儿童耐甲氧西林金黄色葡萄球菌菌血症相对少见，主要发生在非常年幼的儿童中，通常是那些接受新生儿或儿科重症监护的儿童。菌血症主要涉及与医院感染相关的有记录在案的流行株的 MRSA。
