Changing epidemiology of methicillin-resistant Staphylococcus aureus colonization in paediatric intensive-care units.
HERMOS, C. R. 1,*; SANDORA, T. J. 2,3; WILLIAMS, L. E. 2; MOSAMMAPARAST, N. 4; MCADAM, A. J. 2
[Miscellaneous Article] Epidemiology & Infection. 141(9):1983-1992, September 2013.

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SUMMARY: Community-associated methicillin-resistant S. aureus (CA-MRSA) accounts for a growing proportion of hospital-onset infections, and colonization is a risk factor. This study aimed to determine changes in the prevalence of CA-MRSA colonization in paediatric intensive-care units (ICUs). A total of 495 paediatric patients colonized with MRSA from neonatal, medical, surgical, and cardiac ICUs between 2001 and 2009 were identified. Isolates were characterized by spa type, staphylococcal cassette chromosome (SCC) mec type and the presence of the genes encoding Panton-Valentine leukocidin (PVL). The proportion of patients colonized with MRSA remained stable (average 3[middle dot]2%). The proportion of isolates with spa type 1, SCCmec type IV and PVL increased over time to maximums in 2009 of 36[middle dot]1% (P < 0[middle dot]001), 54[middle dot]2% (P = 0[middle dot]03) and 28[middle dot]9% (P = 0[middle dot]003), respectively. Antibiotic susceptibility patterns showed increasing proportions susceptible to clindamycin, gentamicin, tetracycline and trimethoprim-sulfamethoxazole (P values <0[middle dot]001). In conclusion, the proportion of MRSA-colonized children in ICUs with CA-MRSA increased significantly over time.

(C) Cambridge University Press 2013