422. Weight-For-Age Percentile and Risk in Pediatric Patients with Community Acquired Methicillin Resistant Staphylococcus aureus in Houston, TX: 2008-2011
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Moraros_WFA CA-MRSA.pdf (460.0 kB)
  • Background: Weight has been implicated as a risk factor for symptomatic community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA). Information from Texas Children’s Hospital (TCH) in Houston, TX was used to implement a case-control study to assess weight-for-age percentile (WFA), race and seasonal exposure as risk factors.

    Methods: A retrospective chart review to collect data from TCH was conducted covering the time period January 1st, 2008 to May 31st, 2011. Cases were confirmed and identified through the S. aureus surveillance study database at TCH and were matched on a 1:1 ratio to controls that were seen by the emergency department for non-infected fractures from June 1st, 2008 to May 31st, 2011. Data abstraction was performed using TCH’s electronic medical records (EMR) system (EPIC ®). 

    Results: Of 702 CA-MRSA identified cases, ages 9 to 16.99, 564 (80.3%) had the variable ‘weight’ present in their EMR, were not duplicates and not determined to be outliers. Cases were randomly matched to a pool of available controls (n=1864) according to age and gender, yielding 539 1:1 matched pairs (95.5% case matching success) and a total study sample size, N=1078. Case median age was 13.38 years with the majority being White (66.05%) and male (59.4%). Adjusted conditional logistic regression analysis of the matched pairs identified the following risk factors to presenting with CA-MRSA infection among pediatric patients, ages 9 to 16.99 years: a) Individual weight in the highest (75th-99.9th) WFA quartile (OR=1.36; 95% confidence interval [CI]=1.06-1.74; P= 0.016), b) Infection during summer months (OR: 1.69; 95% CI=1.2-2.38; P= 0.003), c) patients of African American race/ethnicity (OR= 1.48; 95% CI=1.13-1.95; P= 0.004). 

    Conclusion: Pediatric patients, 9 to 16.99 years of age, in the highest WFA quartile (75th-99.9th), or of African-American race had an associated increased risk of presenting with CA-MRSA infection. Furthermore, children in this population were at a higher risk of contracting CA-MRSA infection during the summer season.

    Spyridon Moraros, MSPH1, Eric Brown, PhD1, Edward O. Mason, PhD2 and Sheldon L. Kaplan, MD, FIDSA3, (1)Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center At Houston, Houston, TX, (2)Baylor College of Medicine and Texas Children's Hospital, Houston, TX, (3)Pediatrics, Baylor College of Medicine and Texas Chldren's Hospital, Houston, TX


    S. Moraros, None

    E. Brown, None

    E. O. Mason, None

    S. L. Kaplan, None

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