Sasan Mohammadsaeed, Donyadide Nahid, Askari Emran, Naderi-Nasab Mahboobeh
Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran.
Students Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Microbiol. 2014 Apr;6(2):84-6.
Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly reported worldwide. We aimed to determine the frequency of invasive CA-MRSA in children admitted to the pediatric wards of Imam Reza and Ghaem hospitals of Mashhad, Iran.
In this retrospective study, data regarding S. aureus isolates from pediatric patients' sterile body sites (i.e. blood' joint, bone and lymph node aspiration) were retrieved in a time period from March 2006 to March 2012. Disc diffusion data was analyzed to determine the resistance pattern of the isolates, and differentiation between community-acquired and nosocomial S. aureus was done according to CDC guidelines.
Twenty three invasive community-acquired S. aureus isolates from sterile body sites were identified, of which seventeen (74%) were CA-MRSA. The CA-MRSA isolates showed high frequency of resistance to non-β-lactam antibiotics (71% to erythromycin' 53% to co-trimoxazole, 44% to gentamicin and 36% to ciprofloxacin).
In this study, the majority of invasive community-acquired S. aureus isolates were found to be CA-MRSA. Therefore, we recommend that primary treatment should be with antibiotics such as clindamycin, vancomycin, linezolid or daptomycin for any invasive infection suspected to be caused by S. aureus in these two hospitals.
社区获得性耐甲氧西林金黄色葡萄球菌（CA-MRSA）在全球范围内的报道日益增多。我们旨在确定伊朗马什哈德伊玛目礼萨医院和加姆医院儿科病房收治儿童中侵袭性CA-MRSA的发生频率。
在这项回顾性研究中，收集了2006年3月至2012年3月期间儿科患者无菌身体部位（即血液、关节、骨骼和淋巴结穿刺液）分离出的金黄色葡萄球菌的数据。分析纸片扩散法数据以确定分离株的耐药模式，并根据美国疾病控制与预防中心（CDC）指南区分社区获得性和医院内金黄色葡萄球菌。
从无菌身体部位鉴定出23株侵袭性社区获得性金黄色葡萄球菌分离株，其中17株（74%）为CA-MRSA。CA-MRSA分离株对非β-内酰胺类抗生素耐药频率较高（对红霉素耐药率为71%、对复方新诺明为53%、对庆大霉素为44%、对环丙沙星为36%）。
在本研究中，大多数侵袭性社区获得性金黄色葡萄球菌分离株被发现为CA-MRSA。因此，我们建议对于这两家医院中任何疑似由金黄色葡萄球菌引起的侵袭性感染，初始治疗应使用克林霉素、万古霉素、利奈唑胺或达托霉素等抗生素。
