418. Burden of Staphylococcus aureus (SA) Infections in Children: Eleven - Year Trend in the Incidence of SA Infections
Session: Poster Abstract Session: Pediatric Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • poster_418_song.JPG (141.6 kB)
  • Background: Recent studies have suggested that the incidence of infections caused by methicillin resistant Staphylococcus aureus (MRSA) has decreased in selected population such as hospitalized pediatric patients with central lines and military personnel.

    Methods: This retrospective cohort study included pediatric patients with SA infections that were identified in our institution between 7/2000 and 6/2012. Infections were further characterized as community-associated (CA) if culture was obtained in the emergency department, outpatient clinics, or within 48 hours of admission, and by type of infection. Annual IR, defined as incident SA infections per 1000 patient-visits (PV), and proportion of MRSA of all SA infections was compared using Poisson Regression and chi-square test, respectively.

    Results: Of 8504 patients that met the criteria, 4386, 3913, and 205 patients had one or more episode of MRSA infection alone, methicillin susceptible SA (MSSA) infection alone, or both MRSA and MSSA infection during the study period. The IR per 1000 PV increased between 2001 and 2007 from 1.8 to 7.8 (IR Ratio [IRR] =1.2, p<0.001) for all SA infections and from 0.2 to 5.0 (IRR =1.8, p<0.001) for MRSA infections, and fell to 5.0 (IRR=0.9, p<0.001) for all SA infections and to 2.7(IRR=0.9, p<0.001) for MRSA infections by 2012. Of all SA infections, the proportion of MRSA rose between 2001 and 2007 from 13% to 63% (p<0.001) and fell to 53% by 2012 (p<0.001) (Fig1). Of MRSA infections, the proportion of CA-MRSA rose from 59% in 2001 to 95% in 2012; soft tissue infections rose from 71% in 2001-2004 to 91% in 2005-2012, and bloodstream infections decreased from 10% in 2001-2004 to 2.6% in 2005-2012.  8% of patients with either a MRSA or a MSSA infection required one or more hospital re-visit within one year following the first episode of SA infection.

    Conclusion: This study described a decreasing trend of SA infections, predominately due to the decrease of MRSA infections, in children since 2007. Further studies are warranted to determine contributing factors that will shed light on the development of effective MRSA prevention strategies.

    Xiaoyan Song, PhD, MBBS, George Washington University School of Medicine, Washington, DC and Roberta Debiasi, MD, Children's National Medical Center/Children's Research Institute, Washington, DC; Division of Pediatric Infectious Diseases, Children's National Medical Center/GWU School of Medicine, Washington, DC


    X. Song, None

    R. Debiasi, None

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