Journal of medical microbiology · 2017
How do the epidemiology of paediatric methicillin-resistant Staphylococcus aureus and methicillin-susceptible Staphylococcus aureus bacteraemia differ?
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Abernethy Julia, Sharland Mike, Johnson Alan P, Hope Russell
Аннотация
PURPOSE: To examine whether the epidemiology of bacteraemia caused by methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA) differed in children aged <1 year and in comparison to older age groups.
METHODOLOGY: English mandatory MRSA and MSSA surveillance data from 2006 and 2011, respectively, were collected. Epidemiological information was descriptively analysed in relation to methicillin susceptibility and patient age. Ninety-five percent confidence intervals (CIs) are reported.Results/Key findings. The average incidence rate of MSSA and MRSA bacteraemia in <1-year-olds was 60.2 and 4.8 episodes per 100 000 population per year, respectively. Of the cases of MSSA bacteraemia in children aged <1 year, 47.5 % (95 % CI: 45.1-50.0; n=760/1 599) were in neonates. With increasing age up to one year, more MSSA bacteraemias were detected ≥7 days after admission, ranging from 0 % (95 % CI: 0-2.5 %) in 0-2-day-olds to 68.4 % (95 % CI: 64.0-72.5 %; 333/487) in 8-28-day-olds and 50.5 % (95 % CI: 47.1-54.0 %; 423/837) in 29 day-1-year-olds, a higher proportion than in older children but similar to MRSA bacteraemia. Amongst <1-year-olds with MSSA bacteraemia, the underlying source was most commonly recorded as intravascular devices [34.4 % (95 %, CI: 30.5-38.6 %); n=190/552] whilst in older age groups this declined. A similar trend was observed for MRSA bacteraemia.
CONCLUSIONS: Our analysis indicates that S. aureus bacteraemia in <1-year-olds is primarily healthcare-associated, unlike MSSA bacteraemia in older age groups. Paediatric-specific interventions targeted at the healthcare setting, such as neonatal unit-specific care bundles and paediatric device-specific strategies, are required.
METHODOLOGY: English mandatory MRSA and MSSA surveillance data from 2006 and 2011, respectively, were collected. Epidemiological information was descriptively analysed in relation to methicillin susceptibility and patient age. Ninety-five percent confidence intervals (CIs) are reported.Results/Key findings. The average incidence rate of MSSA and MRSA bacteraemia in <1-year-olds was 60.2 and 4.8 episodes per 100 000 population per year, respectively. Of the cases of MSSA bacteraemia in children aged <1 year, 47.5 % (95 % CI: 45.1-50.0; n=760/1 599) were in neonates. With increasing age up to one year, more MSSA bacteraemias were detected ≥7 days after admission, ranging from 0 % (95 % CI: 0-2.5 %) in 0-2-day-olds to 68.4 % (95 % CI: 64.0-72.5 %; 333/487) in 8-28-day-olds and 50.5 % (95 % CI: 47.1-54.0 %; 423/837) in 29 day-1-year-olds, a higher proportion than in older children but similar to MRSA bacteraemia. Amongst <1-year-olds with MSSA bacteraemia, the underlying source was most commonly recorded as intravascular devices [34.4 % (95 %, CI: 30.5-38.6 %); n=190/552] whilst in older age groups this declined. A similar trend was observed for MRSA bacteraemia.
CONCLUSIONS: Our analysis indicates that S. aureus bacteraemia in <1-year-olds is primarily healthcare-associated, unlike MSSA bacteraemia in older age groups. Paediatric-specific interventions targeted at the healthcare setting, such as neonatal unit-specific care bundles and paediatric device-specific strategies, are required.