Abstract
Objective: We aimed to investigate the epidemiology and identify antibiotic resistance patterns of isolates from children with skin and soft tissue infections attending an outpatient clinic in Southern China. Method: An observational study of outpatient pediatric patients was conducted in a rural area of Guangxi. Infections were characterized in 230 patients and staphylococcal isolates tested for susceptibility to a range of antibiotics. Results: Among the 307 patients, 38.5% were infants. Culture yielded Staphylococcus aureus (S. aureus) in 230 patients, of which 24 (10.4%) were methicillin-resistant S. aureus (MRSA). Staphylococcal strains were most isolated from hand, foot and umbilicus. The 1-12 mon group had the highest staphylococcal infection rate (86%), followed by the 6-12 year group, but MRSA was more common in the older children (19.5% of S. aureus). MRSA had significantly more resistance than MSSA to chloromycin (46% vs 11%), clindamycin (67% vs 19%), gentamicin (33% vs 2%), rifampicin (25% vs 2.9%), and sulphamthoxazole-trimethoprim (17% vs 3%). Conclusion: S. aureus remains a leading cause of pediatric skin and soft tissue infections. Over 10% of isolates were methicillin-resistant with high rates of resistance to non-beta lactam antibiotics, reducing options for therapy and limiting choices for empirical treatment.
Highlights
Staphylococcus aureus (SA) is an important pathogen causing infections ranging from superficial skin infections to life threatening conditions [1]
This study aimed to investigate the epidemiology of pediatric STIs in attendees at an outpatient clinic in Southern China and determine the antibiotic resistance profiles of S. aureus isolates
The most common infected sites by S. aureus were hand (90.0%), foot (87.0%) and umbilicus (84.8%), but methicillin-resistant S. aureus (MRSA) were most isolated from foot (20%), hand (18.5%), back and lower limb (14.3%) (Table 1)
Summary
Staphylococcus aureus (SA) is an important pathogen causing infections ranging from superficial skin infections to life threatening conditions [1]. Methicillin-resistant S. aureus (MRSA) evolved in healthcare facilities causing nosocomial infections in both adults and children, but since first reports of community-associated MRSA (CA-MRSA) in children without predisposing risk in 1998 [2], its prevalence continues to increase. The proportion of CA-MRSA isolated from skin and soft tissue infections (SSI) worldwide ranges from 65% to 91% [3,4,5]. The smaller elements often do not harbor additional resistance determinants. Children are prone to staphylococcal infections including impetigo, cellulitis and abscesses, and attendance at childcare facilities increases infection risk [8]
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