Department of Pediatric Infectious Diseases, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira - Fundação Oswaldo Cruz, Avenida Rui Barbosa, 716 - Flamengo, Rio de Janeiro, RJ, 22250-020, Brazil.
BMC Infect Dis. 2024 Sep 30;24(1):1081. doi: 10.1186/s12879-024-09986-7.
In the pediatric population, Staphylococcus aureus infections are responsible for increased morbidity and mortality, length of hospitalization and the cost of inpatient treatment. The aim of this study is to describe the antimicrobial resistance profile of S. aureus isolated in clinical specimens from pediatric patients admitted to a tertiary hospital in Rio de Janeiro, Brazil.
Culture reports and medical records of hospitalized patients under 18 years of age with S. aureus infections between January 2015 and December 2022 were retrospectively analyzed. Information was collected on recent antibiotic use, previous hospital admission, inpatient unit, clinical specimen, time of infection (community or nosocomial), classification according to susceptibility to methicillin (methicillin sensitive - MSSA or methicillin resistant - MRSA) and sensitivity to other antimicrobials. We analyzed the distribution of the sensitivity profile of S. aureus infections over the 7 years evaluated in the study.
Were included 255 unique clinical episodes, among which the frequencies of MSSA and MRSA were 164 (64%) and 91 (36%), respectively. Over the 7 years evaluated, there was stability in the prevalence percentage, with a predominance of MSSA in the range of 60 to 73.3%, except in 2020, when there was a drop in the prevalence of MSSA (from 73.3% in 2019 to 52.5%) with an increase in MRSA (from 26.7% in 2019 to 47.5%). Ninety-seven (38%) infections were community-acquired and 158 (62%) were healthcare-associated. The main clinical specimens collected were blood cultures (35.2%) and wound secretions (17%). The MRSA isolates presented percentages of sensitivity to trimethoprim-sulfamethoxazole from 90.4 to 100%, and to clindamycin from 77 to 89.8% in MRSA healthcare associated and MRSA community respectively.
There was a constant predominance in the prevalence of MSSA with percentage values maintained from 2015 to 2022, except in 2020, in which there was a specific drop in the prevalence of MSSA with an increase in MRSA. MSSA infections are still predominant in the pediatric population, but MRSA rates also present significant values, including in community infections, and should be considered in initial empiric therapy.
在儿科人群中，金黄色葡萄球菌感染会导致发病率和死亡率增加、住院时间延长以及住院治疗费用增加。本研究旨在描述巴西里约热内卢一家三级医院儿科患者临床标本中分离的金黄色葡萄球菌的抗菌药物耐药谱。
回顾性分析 2015 年 1 月至 2022 年 12 月期间金黄色葡萄球菌感染的住院 18 岁以下患者的培养报告和病历。收集了近期抗生素使用情况、既往住院史、住院科室、临床标本、感染时间（社区或医院内）、耐甲氧西林分类（甲氧西林敏感- MSSA 或耐甲氧西林- MRSA）和其他抗菌药物敏感性等信息。我们分析了研究期间 7 年中金黄色葡萄球菌感染的敏感性谱分布情况。
共纳入 255 例独特的临床病例，其中 MSSA 和 MRSA 的频率分别为 164 例（64%）和 91 例（36%）。在评估的 7 年中，MSSA 的流行率百分比保持稳定，60%至 73.3%之间占主导地位，除了 2020 年，MSSA 的流行率下降（从 2019 年的 73.3%降至 52.5%），MRSA 的流行率上升（从 2019 年的 26.7%升至 47.5%）。97 例（38%）感染为社区获得性，158 例（62%）为医源性。采集的主要临床标本为血培养（35.2%）和伤口分泌物（17%）。MRSA 分离株对 trimethoprim-sulfamethoxazole 的敏感性百分比为 90.4%至 100%，对克林霉素的敏感性百分比为 77%至 89.8%，分别为医源性 MRSA 和社区获得性 MRSA。
除了 2020 年，MSSA 的流行率始终占主导地位，2015 年至 2022 年期间，MSSA 的百分比值保持不变，而 2020 年，MSSA 的流行率特异性下降，MRSA 流行率上升。儿科人群中 MSSA 感染仍占主导地位，但 MRSA 率也有显著升高，包括社区感染，在初始经验性治疗时应考虑。
