Resumen

PAGANINI, Hugo et al. Infecciones causadas por Staphylococcus aureus resistentes a la meticilina en niños provenientes de la comunidad en niños de la Argentina. Arch. argent. pediatr. [online]. 2006, vol.104, n.4, pp.295-300. ISSN 0325-0075.

Introduction. Community acquired methicillin-resistant Staphylococcus aureus infections without known risk factors have dramatically increased in the last years worldwide. In Argentina, these infections have not been reported in children. Objectives. To analyze the epidemiological, clinical and outcome features, as well as to identify risk factors for the acquisition of community-acquired methicillin-resistant S. aureus infections in children. Population, material and methods. This was a prospective and descriptive study of community acquired methicillin-resistant S. aureus infections. A comparative analysis with methicillin-sensitive S. aureus infections of the same origin was performed. Infections were classified as community-acquired when cultures were obtained from the infection site at the office visit and did not fulfill the US CDC^TMs criteria for nosocomial infections. Results. Between July 2004 and July 2005, 200 infections were diagnosed in 199 children. 38% (76) of them were community-acquired. From these, 42% (32) were methicillin-resistant. The median age of these patients was 6 years. The mean number of household contacts was 5.3. In 28% of the children, an underlying disease was detected, and 59% of the patients reported a previous visit to their physicians in the previous 6 months. Skin and soft tissues infections prevailed, followed by pneumonias. 12% of the children had bacteriemia and fever was present in 65% of them. Nearly all the strains were sensitive to trimethoprim-sulfametoxazole and clindamycin. No deaths occurred. The comparative analysis did not show statistically significant differences in the analyzed risk factors. A higher frequency of subcutaneous abscesses (44% vs. 9%), higher leukocytosis (18,590/mm³ vs. 13,008/mm³), and a higher proportion of discordant treatment at admission (75% vs. 39%) were seen in children with methicillin-resistant S aureus infections than in those infected with methicillin-sensitive strains (p< 0.05). Conclusion. We are alerting on the emergence of these infections in Argentina. This pathogen should be considered in children with severe community-acquired infections in order to prescribe an appropriate empirical treatment. No differences in risk factors for the acquisition of these infections or those caused by methicillin-sensitive strains were observed.

Palabras clave : Methicillin-resistant Staphylococcus aureus; Community-acquired infections.

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