Department of Dermatology and Venereology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Int J Dermatol. 2012 Dec;51(12):1441-7. doi: 10.1111/j.1365-4632.2012.05515.x. Epub 2012 Aug 28.
Community-associated methicillin-resistant Staphylococci aureus (CA-MRSA) pediatric skin infections have been reported worldwide. However, little is known about pathogens' implications in Egyptian children, and beta-lactams are still the empiric antimicrobials prescribed. This warrants Egyptian studies on antibiogram testing of pediatric skin infections.
To determine antibiotic susceptibility patterns of bacterial isolates from Egyptian pediatric skin infections to find out if we need reconsideration of the empiric beta-lactam antimicrobial therapy.
Throughout an eight-month cross-sectional study, antibiogram testing was conducted on bacterial isolates from pediatric skin infections. Determination of inducible resistance to clindamycin using D-test was performed for isolates susceptible to clindamycin and resistant to erythromycin.
One-hundred and 21 children (mean age 6.9 years ± 3 SD) presented with pyogenic skin infections. Methicillin-sensitive Staphylococci aureus (MSSA) were isolated from 114 children, associated with group A Streptococci (GAS) in four of them, while GAS were the only isolates in three patients. A diagnosis of CA-MRSA was fulfilled in four children. Antibiotic susceptibilities differed between isolated organisms but with no statistically significant differences between susceptibility patterns of isolates from primary skin infections and those from secondary infection of skin diseases. Positive D-test was detected in five MSSA isolates.
CA-MRSA skin infections are not common among Egyptian children and, therefore, beta-lactams are still effective empiric antimicrobial therapy for most infections. Antibiogram testing from suppurative skin lesions are, however, better to be recommended to guide individual therapy. Clindamycin should not be considered for susceptible isolates unless they are erythromycin susceptible or D-test negative.
社区相关性耐甲氧西林金黄色葡萄球菌（CA-MRSA）儿科皮肤感染已在全球范围内报道。然而，对于埃及儿童的病原体影响知之甚少，并且β-内酰胺类药物仍然是经验性的抗菌药物。这就需要在埃及进行儿科皮肤感染的药敏试验研究。
确定来自埃及儿科皮肤感染的细菌分离株的抗生素敏感性模式，以确定是否需要重新考虑经验性β-内酰胺类抗菌药物治疗。
在一项为期 8 个月的横断面研究中，对儿科皮肤感染的细菌分离株进行了药敏试验。对克林霉素敏感但对红霉素耐药的分离株进行 D 试验，以确定克林霉素诱导耐药性。
121 名儿童（平均年龄 6.9 岁±3SD）出现化脓性皮肤感染。114 名儿童分离出甲氧西林敏感金黄色葡萄球菌（MSSA），其中 4 名与 A 组链球菌（GAS）相关，3 名患者仅分离出 GAS。4 名儿童被诊断为 CA-MRSA。分离株的抗生素敏感性存在差异，但原发性皮肤感染和皮肤病继发感染分离株的敏感性模式之间无统计学差异。在 5 株 MSSA 分离株中检测到阳性 D 试验。
CA-MRSA 皮肤感染在埃及儿童中并不常见，因此β-内酰胺类药物仍然是大多数感染的有效经验性抗菌药物治疗。然而，更好的做法是建议对脓性皮肤病变进行药敏试验，以指导个体化治疗。除非克林霉素敏感且 D 试验阴性，否则不应将克林霉素用于敏感分离株。
