Tue, Aug 12, 2025
1- Department of Pediatrics, Government Medical College (GMC), Srinagar, Jammu and Kashmir, India
2- Department of Pediatric Microbiology, Government Medical College (GMC), Srinagar, Jammu and Kashmir, India
3- Department of Pediatrics, Government Medical College (GMC), Srinagar, Jammu and Kashmir, India ,dromarqureshi@rediffmail.com
2- Department of Pediatric Microbiology, Government Medical College (GMC), Srinagar, Jammu and Kashmir, India
3- Department of Pediatrics, Government Medical College (GMC), Srinagar, Jammu and Kashmir, India ,
Abstract: (575 Views)
Background: Staphylococcus aureus (S. aureus) is a virulent bacterium responsible for a spectrum of infections, from superficial dermatological issues to severe, life-threatening sepsis. The emergence of methicillin-resistant S. aureus (MRSA) strains, encompassing both hospital-acquired (HA) and community-acquired (CA) variants, presents significant challenges to effective treatment, especially in pediatric sepsis cases. This research endeavored to characterize S. aureus sepsis in pediatric patients, differentiate between cases caused by CA S. aureus (CA-SA) and HA S. aureus (HA-SA), and evaluate patterns of antibiotic resistance.
Methods: This study, conducted between January 2021 and December 2022 at the Postgraduate Department of Pediatrics, Children’s Hospital, Srinagar, Kashmir, J&K, investigated patients aged 1 month to 18 years with suspected S. aureus sepsis or disseminated disease. Standard methods (BacT Alert and Vitek II Compact) were employed for culturing various samples. Continuous data are presented as mean ± standard deviation (SD), while categorical variables are expressed as proportions.
Results: Out of 56 patients, CA-SA was observed in 66.1% of cases, while HA-SA accounted for the remaining 33.9%. The cohort primarily consisted of males (62.5%) and individuals residing in rural areas (71.43%). Localized musculoskeletal symptoms were a prominent feature, present in 91.9% of patients (P ≤ 0.05). Pleuropulmonary disease showed an association with HA-SA, whereas necrotizing soft tissue infections were linked to CA-SA. Common clinical manifestations included pneumonia and abscesses. Complications (such as septic shock, respiratory failure, and multi-organ dysfunction) were more frequently encountered in patients with HA-SA. Among 50 culture-confirmed cases, 96% were identified as methicillin-resistant S. aureus (MRSA). Survival rates differed between the two groups, with 94.6% for CA-SA patients and 89.5% for HA-SA patients.
Conclusion: The current study reveals a high prevalence of MRSA in pediatric sepsis, emphasizing the critical need for urgent antimicrobial stewardship. The observed distinct clinical profiles of CA-SA and HA-SA further underscore the necessity for tailored management strategies, particularly in resource-limited environments.
Methods: This study, conducted between January 2021 and December 2022 at the Postgraduate Department of Pediatrics, Children’s Hospital, Srinagar, Kashmir, J&K, investigated patients aged 1 month to 18 years with suspected S. aureus sepsis or disseminated disease. Standard methods (BacT Alert and Vitek II Compact) were employed for culturing various samples. Continuous data are presented as mean ± standard deviation (SD), while categorical variables are expressed as proportions.
Results: Out of 56 patients, CA-SA was observed in 66.1% of cases, while HA-SA accounted for the remaining 33.9%. The cohort primarily consisted of males (62.5%) and individuals residing in rural areas (71.43%). Localized musculoskeletal symptoms were a prominent feature, present in 91.9% of patients (P ≤ 0.05). Pleuropulmonary disease showed an association with HA-SA, whereas necrotizing soft tissue infections were linked to CA-SA. Common clinical manifestations included pneumonia and abscesses. Complications (such as septic shock, respiratory failure, and multi-organ dysfunction) were more frequently encountered in patients with HA-SA. Among 50 culture-confirmed cases, 96% were identified as methicillin-resistant S. aureus (MRSA). Survival rates differed between the two groups, with 94.6% for CA-SA patients and 89.5% for HA-SA patients.
Conclusion: The current study reveals a high prevalence of MRSA in pediatric sepsis, emphasizing the critical need for urgent antimicrobial stewardship. The observed distinct clinical profiles of CA-SA and HA-SA further underscore the necessity for tailored management strategies, particularly in resource-limited environments.
Research Article: Original Paper |
Subject:
Microbiology
Received: 2023/12/11 | Accepted: 2024/10/12
Received: 2023/12/11 | Accepted: 2024/10/12
References
1. Nilsson P, Ripa T. Staphylococcus aureus throat colonization is more frequent than colonization in the anterior nares. J Clin Microbiol. 2006;44(9):3334-9. [View at Publisher] [DOI] [PMID] [Google Scholar]
2. Kaplan SL, Hulten KG, Gonzalez BE, Hammerman WA, Lamberth L, Versalovic J,et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis. 2005;40(12):1785-91. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol .2009;7(9):629-41. [View at Publisher] [DOI] [PMID] [Google Scholar]
4. Jevons MP, Coe AW, Parker MT. Methicillin resistance in staphylococci. Lancet. 1963;1(7287):904-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
5. Humphreys H, Grundmann H, Skov R, Lucet JC, Cauda R. Prevention and control of methicillin-resistant Staphylococcus aureus. Clin Microbiol Infect. 2009;15(2):120-4. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Eriksen KR. "Celbenin"-resistant staphylococci. Ugeskr Laeger. 1961;123:384-6. [View at Publisher] [PMID] [Google Scholar]
7. David MZ, Daum RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev. 2010;23(3):616-87. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Schlapbach LJ, Straney L, Alexander J, MacLaren G, Festa M, Schibler A, et al. Mortality related to invasive infections, sepsis, and septic shock in critically ill children in Australia and New Zealand, 2002-13: a multicentre retrospective cohort study. Lancet Infect Dis. 2015;15(1):46-54. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Riviello ED, Sugira V, Twagirumugabe T. Sepsis research and the poorest of the poor. Lancet Infect Dis. 2015;15(5):501-3 [View at Publisher] [DOI] [PMID] [Google Scholar]
10. Buck JM, Como-Sabetti K, Harriman KH, Danila RN, Boxrud DJ, Glennen A, et al. Community-associated methicillin-resistant Staphylococcus aureus, Minnesota, 2000-2003. Emerg Infect Dis. 2005;11(10):1532-8. [View at Publisher] [DOI] [PMID] [Google Scholar]
11. Wani N, Bali N, Bashir L, Ahmad J, Ahmad S. Comparison of Automated System Vitek-2 with Conventional Methods, for Identification and Antibiotic Sensitivity in Gram Positive Organisms. Jms. 2019;22(2):12-7. [View at Publisher] [DOI] [Google Scholar]
12. Bathla A, Rakholia R, Choudhary B, Arya A. Clinico-bacteriological profile and outcome of children with pneumonia under 5 years of age. Chrismed Journal of Health and Research. 2020;7(30):156-61. [View at Publisher] [DOI] [Google Scholar]
13. Karode P, Biswas M, Bharani A, Jain H. Clinico-bacteriological Profile of Pneumonia, Meningitis and Sepsis in under Five Children from a Tertiary Care Hospital in Central India. J Clin of Diagn Res.2021;15(9):SC10-SC14. [View at Publisher] [DOI] [Google Scholar]
14. Eshetie S, Unakal C, Gelaw A, Ayelign B, Endris M, Moges F. Multidrug resistant and carbapenemase producing Enterobacteriaceae among patients with urinary tract infection at referral Hospital, Northwest Ethiopia. Antimicrob Resist Infect Control. 2015;4:12. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Baranwal AK, Singhi SC, Jayashree M. A 5-year PICU experience of disseminated staphylococcal disease, part 1: clinical and microbial profile. J Trop Pediatr. 2007;53(4):245-51. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Mathews CJ, Weston VC, Jones A, Field M, Coakley G. Bacterial septic arthritis in adults. Lancet. 2010;375(9717):846-55. [View at Publisher] [DOI] [PMID] [Google Scholar]
17. Rello J, Valenzuela-Sánchez F, Ruiz-Rodriguez M, Moyano S. Sepsis: A Review of Advances in Management. Adv Ther. 2017;34(11):2393-2411. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. Wong HR, Shanley TP, Sakthivel B, Cvijanovich N, Lin R, Allen GL,et al .Genomics of Pediatric SIRS/Septic Shock Investigators. Genome-level expression profiles in pediatric septic shock indicate a role for altered zinc homeostasis in poor outcome. Physiol Genomics. 2007;30(2):146-55. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Qadri I, Malik I, Ahmed K. Staphylococcus aureus infection in a pediatric ICU: a hospital based prospective observational study. Indian J Crit Care Med. 2019;23(5):210-12. [View at Publisher] [DOI] [PMID] [Google Scholar]
20. Sabouni F, Ranjbari R, Pourakbari B, Mahmoudi S, Teymuri M, Ashtiani MTH, et al. Staphylococcus aureus infections in children in an Iranian referral pediatric hospital. J Prev Med Hyg. 2013;54(4):205-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
21. Camacho-Cruz J, Gutiérrez IF, Brand-López K, Sosa-Rodríguez YA, Vásquez-Hoyos P, Gómez-Cortés LC, et al. Differences Between Methicillin-susceptible Versus Methicillin-resistant Staphylococcus aureus Infections in Pediatrics: Multicenter Cohort Study Conducted in Bogotá, Colombia, 2014-2018. Pediatr Infect Dis J. 2022;41(1):12-19. [View at Publisher] [DOI] [PMID] [Google Scholar]
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.