Staphylococcus aureus Infections in Children: The Implications of Changing Trends.

Abstract

* Abbreviations: CA — : community-acquired MRSA — : methicillin-resistant Staphylococcus aureus SSTI — : skin and soft tissue infections In this issue of Pediatrics , Sutter et al1 report the antibiotic susceptibility trends of Staphylococcus aureus isolates recovered from >39 000 children who received care at sites within the US military health system from 2005 through 2014. S aureus is the most common pathogen causing skin and soft tissue infections (SSTIs) as well as some invasive infections such as osteomyelitis and septic arthritis in children.2 S aureus is also 1 of the most common organisms isolated from children with health care–associated infections, regardless of whether these infections had their onset in the community or were acquired in the hospital. Thus, the initial empiric treatment of an SSTI or invasive infection in a child almost always includes an antibiotic effective against S aureus . Before the 1990s, penicillinase-resistant β-lactam antibiotics with activity against methicillin-susceptible S aureus isolates (methicillin, nafcillin, oxacillin, or cefazolin for invasive infections or oral agents such as dicloxacillin or cephalexin for outpatient SSTIs) were typically administered for suspected staphylococcal infections with onset in the community. Up until that time, methicillin-resistant S aureus (MRSA) isolates were almost always associated with hospital-acquired infections. In the late 1990s and early … Address correspondence to Sheldon L. Kaplan, MD, Texas Children's Hospital, Feigin Center, Suite 1150, 1102 Bates, Houston, TX 77030. E-mail: skaplan{at}bcm.edu