原创力文档higher incidence of perineal community acquired mrsa infections among toddlers提高幼儿的会阴社区获得性耐甲氧西林金黄色葡萄球菌感染的发生率.pdfVIP
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higher incidence of perineal community acquired mrsa infections among toddlers提高幼儿的会阴社区获得性耐甲氧西林金黄色葡萄球菌感染的发生率
McCullough et al. BMC Pediatrics 2011, 11:96
/1471-2431/11/96
RESEARCH ARTICLE Open Access
Higher incidence of perineal community acquired
MRSA infections among toddlers
1 1 2 3 4 4
Alexis C McCullough , Melissa Seifried , Xiaochen Zhao , Jeffrey Haase , William J Kabat , Ram Yogev ,
Robert M Blumenthal5,6 and Deepa Mukundan2,5*
Abstract
Background: A six-fold increase in pediatric MRSA infections, prompted us to examine the clinical profile of
children with MRSA infections seen at Mercy Children’s Hospital, Toledo, Ohio and to characterize the responsible
strains.
Methods: Records were reviewed of pediatric patients who cultured positive for MRSA from June 1 to December
31, 2007. Strain typing by pulsed field gel electrophoresis (PFT) and DiversiLab, SCCmec typing, and PCR-based
lukSF-PV gene (encodes Panton-Valentine leukocidin), arginine catabolic mobile element (ACME) and cap5 gene
detection was performed.
Results: Chart review of 63 patients with MRSA infections revealed that 58(92%) were community acquired MRSA
(CAMRSA). All CAMRSA were skin and soft tissue infections (SSTI). Twenty five (43%) patients were aged 3 yrs, 19
(33%) aged 4-12 and 14(24%) aged 13-18. Nineteen (76%) of those aged 3 yrs had higher incidence of perineal
infections compared to only 2(11%) of the 4-12 yrs and none of the 13-18 yrs of age. Infections in the extremities
were more common in the older youth compared to the youngest children. Overall, there was a significant
association between site of the infection and age group (Fisher’s Exact p-value 0.001). All CAMRSA were USA300
PFT, clindamycin susceptible, SCCmec type IVa and lukSF-PV gene positive. Nearly all contained ACME and about
80% were cap5 positive. Of th
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