2018 - 2021年哥伦比亚儿科感染的流行病学和微生物学特征：一项全国多中心研究（哥伦比亚葡萄球菌研究）
Epidemiological and microbiological characteristics of pediatric infections in Colombia 2018-2021, a national multicenter study (Staphylored Colombia).
作者信息
Gutierrez-Tobar Ivan, Carvajal Cristobal, Vasquez-Hoyos Pablo, Díaz-Díaz Alejandro, Londono Ruiz Juan Pablo, Andrade Joam, Camacho-Cruz Jhon, Restrepo-Gouzy Andrea, Trujillo-Honeysberg Monica, Mesa-Monsalve Juan Gonzalo, Perez Ignacio, Von Moltke Richard, Beltran-Echeverry Maria, Toro Jessica F, Niño Angela P, Camacho-Moreno Germán, Calle-Giraldo Juan Pablo, Cabeza Nancy Yhomara, Sandoval-Calle Lina Marcela, Perez Camacho Paola, Patiño Niño Jaime, Araque-Muñoz Paula, Rodríguez-Peña Yazmin, Beltran-Arroyave Claudia, Chaucanez-Bastidas Yamile, Lopez Juan, Galvis-Trujillo Diego, Beltrán-Higuera Sandra, Marino Ana-Cristina, González Leal Natalia, Luengas Monroy Miguel Ángel, Hernandez-Moreno Derly Carolina, Vivas Trochez Rosalba, Garces Carlos, López-Medina Eduardo
机构信息
Department of Pediatrics, Clínica Infantil Santa Maria Del Lago, Bogotá, Colombia.
Department of Pediatrics, Clinica Infantil Colsubsidio, Bogotá, Colombia.
出版信息
Front Pediatr. 2024 Jun 4;12:1386310. doi: 10.3389/fped.2024.1386310. eCollection 2024.
BACKGROUND
infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of in this patient group.
METHODS
We analyzed isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant (MRSA) isolates.
RESULTS
Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA.
CONCLUSIONS
This is the largest study of pediatric infections in Colombia. We found MSSA predominance, but resistance have important regional variations. remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.
背景
感染是全球儿科人群发病和死亡的重要原因。葡萄球菌研究网络在2018年至2021年期间对哥伦比亚各地的儿科患者进行了广泛研究。本研究的目的是描述该患者群体中葡萄球菌感染的流行病学和微生物学特征。
方法
我们分析了来自世界卫生组织（WHO）报告中心的分离株。“事件”定义为在先前检测为阴性的个体中，两周后培养出阳性菌株。我们研究了中心特征、年龄分布、感染类型和抗生素敏感性，并比较了甲氧西林敏感金黄色葡萄球菌（MSSA）和耐药金黄色葡萄球菌（MRSA）分离株。
结果
纳入了来自哥伦比亚7个城市20个中心的分离株。大多数中心（80%）同时服务成人和儿童，55%提供肿瘤学服务，85%设有儿科重症监护病房（PICU）。我们记录了4821例患者的8157次金黄色葡萄球菌培养分离事件（3345例MSSA和1961例MRSA），中位年龄为5岁。血液（26.2%）和皮肤/软组织（18.6%）是最常见的感染源。每次事件中的大多数分离株对苯唑西林（63.2%）、克林霉素（94.3%）和复方磺胺甲恶唑（98.3%）仍敏感。MRSA患病率因城市而异（<0.001），在专科医院中略高。相比之下，在设有抗菌药物管理计划（ASP）的中心，MRSA感染率略低。MRSA主要从骨关节炎感染和多个病灶中分离出来，而与MRSA相比，MSSA更常与复发性感染相关。
结论
这是哥伦比亚最大规模的儿科金黄色葡萄球菌感染研究。我们发现MSSA占主导地位，但耐药性存在重要的地区差异。金黄色葡萄球菌对其他常用抗生素如复方磺胺甲恶唑和克林霉素仍敏感。持续监测金黄色葡萄球菌感染对于了解其在儿童中的行为至关重要。葡萄球菌拉丁美洲研究小组正在进行前瞻性研究，以进行更全面的临床和基因特征分析。
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