[METHICILLIN-RESISTANT VS. METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS (MRSA VS. MSSA) INFECTIONS IN CHILDREN IN SOUTHERN ISRAEL].

INTRODUCTION

Methicillin-resistant Staphylococcus aureus (MRSA) is a major cause of morbidity. Data regarding MRSA infections in children in Israel are scarce.

OBJECTIVES

We assessed MRSA prevalence, risk factors and clinical manifestations in children with Staphylococcus aureus infections in southern Israel.

METHODS

Our medical center is the sole hospital in southern Israel. All medical files of Staphylococcus aureus infections during the period 2005-2015, were reviewed retrospectively.

RESULTS

Overall, 1,062 SA infections (MRSA; n=164, 15%) were identified; 687 (65%) skin and soft tissue infections (SSTI), and 375 (35%) invasive infections. MRSA was significantly more common in children <5 years (18% vs. 13% in children ≥5 years), Bedouin ethnicity (19% vs. 8% in Jewish children), burns (24% vs. 15%), congenital insensitivity to pain with anhidrosis (CIPA; 90% vs. 15%) and SSTI (17% vs. 12% in invasive infections). Blood count parameters and hospital-associated vs. community-acquired infection rates were similar comparing MRSA and Methicillin-susceptible Staphylococcus aureus (MSSA). In multivariate analysis, age (odds ratio, OR=0.953), Bedouin ethnicity (OR=2.698), burns (OR=2.036) and SSTI (OR=1.674) were associated with MRSA. MRSA isolates were more frequently resistant than MSSA to clindamycin (30% vs. 14%), erythromycin (34% vs. 15%), co-trimoxazole, tetracycline, rifampicin, ciprofloxacin and gentamicin (4% vs. 0.5%, all). All isolates were vancomycin susceptible.

CONCLUSIONS

MRSA infections are common in young, Bedouin children and burns, and are more commonly multidrug resistant than MSSA in our region. Our data should be used to better identify and treat children with MRSA infection.