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Recurrent staphylococcal infections most likely from same strain
Children with recurrent staphylococcalinfections most likely have infections from the same staphylococcalstrain, according to recent study findings published in ThePediatric Infectious Disease Journal.
“Recurrent disease due to Staphylococcus aureus has been reported in up to 5% to 49% of pediatric patients, most commonly as recurrent skin and soft tissue infections that can require repeated incision and drainage procedures with or without hospitalization,” Claire. E. Bocchini, MD, of Baylor College of Medicine, and colleagues wrote.
The study included medical records of children with recurrent, culture-proven community-acquired S. aureus(CA-S. aureus) infections at Texas Children’s Hospital in Houston from Aug. 1, 2001, to July 29, 2009, and antibiotic susceptibility patterns for all S. aureusisolates.
Researchers found that 694 otherwise healthy children presented to the hospital with two to seven episodes of CA-S. aureus infections, which accounted for 1,495 visits, 823 hospitalizations and 3,337 inpatient days. Ninety percent of participants with 12 months or less between initial and recurrent infections had the same methicillin susceptibility of the initial and recurrent isolates compared with 79% of participants with more than 12 months between infections. In 71% of otherwise healthy participants, the overall antibiotic susceptibility pattern did not change between isolates compared with 33% of participants with eczema.
Recurrent skin and soft tissue infections were present in 92% of otherwise healthy participants and 8% had at least one non-skin and soft tissue infection. Locations of skin and soft tissue infections varied by age, and children aged 36 months or younger were more likely to have one or more S. aureus infections located in the diaper area.
“Children with recurrent staphylococcalinfections are likely to have repeated infections from the same staphylococcalstrain (by antibiotic susceptibility), indicating that persistent colonization, exposure to others chronically colonized or environmental contamination is playing a role in recurrent disease,” researchers wrote. “Repeat cultures in patients with recurrent disease are still essential, however, as 29% of healthy children and 67% of children with a predisposing risk factor (such as eczema) have a change in the antibiotic susceptibility between S. aureus isolates.”
Disclosure: Bocchini reports support by The Stanley A. Plotkin Sanofi Pasteur Pediatric Infectious Diseases Society Fellowship Award. The study was funded in part by Pfizer.
