Health Care-Associated Infections Caused by Staphylococcus aureus in children in Turkey: A six-year retrospective, single-center study

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-07-01 DOI:10.4103/1995-7645.380721

N. Yakut, Z. Ergenç, Sevgi Tuncay, Sezin Bayraktar, Elvan Sayin, A. İlki, E. Kepenekli

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Abstract

To describe clinical and epidemiological characteristics, antimicrobial susceptibility and mortality-associated factors of healthcare-associated infections (HCAIs) caused by Staphylococcus (S.) aureus in children. We conducted a retrospective, single-centre study of pediatric HCAIs caused by S. aureus from a tertiary care hospital in Turkey between February 2014 and December 2019. The clinical and epidemiological characteristics and antimicrobial susceptibility of the methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA) isolates was evaluated. A total of 310 pediatric patients were examined. Overall, 225 (72.6%) isolates were MSSA and 85 (27.4%) were MRSA. All S. aureus isolates were susceptible to teicoplanin, vancomycin, linezolid, tigecycline, mupirocin, and daptomycin. Penicillin resistance rates were high (89.0%), while fosfomycin, gentamicin, and clindamycin resistance rates were low (1.3%, 1.0%, and 2.3%, respectively). Except susceptibility to fosfomycin, which was significantly lower in 2014 compared to 2018 and 2019, no significant difference was found in the antimicrobial susceptibility of S. aureus isolates between the years. Baseline characteristics and mortality rate were similar comparing MRSA and MSSA causing HCAIs. The mortality rate of HCAIs caused by S. aureus was 6.5% (20 patients). Malignancy was an independent risk factor associated with mortality in the multivariate analysis (OR 5.446, 95% CI 1.573-18.849). Our findings demonstrate that MSSA remained the most causative agent of HCAIs caused by S. aureus. The mortality rate was 6.5%, the antibiotic resistance rate was quite high for penicillin and diagnosis of malignancy was the main risk factor for increasing mortality in children. These findings could help improve the management of HCAIs caused by S. aureus in children.

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土耳其儿童金黄色葡萄球菌引起的医疗保健相关感染：一项为期六年的回顾性单中心研究

描述儿童金黄色葡萄球菌引起的医疗保健相关感染（HCAI）的临床和流行病学特征、耐药性和死亡率相关因素。我们对2014年2月至2019年12月期间土耳其一家三级护理医院由金黄色葡萄球菌引起的儿科HCAI进行了一项回顾性单中心研究。对甲氧西林敏感和耐甲氧西林金黄色葡萄球菌（MSSA和MRSA）分离株的临床、流行病学特征和耐药性进行了评价。共有310名儿科患者接受了检查。总的来说，225个（72.6%）分离株是MSSA，85个（27.4%）是MRSA。所有金黄色葡萄球菌分离株均对替考拉宁、万古霉素、利奈唑胺、替加环素、莫匹罗星和达托霉素敏感。青霉素耐药率高（89.0%），而磷霉素、庆大霉素和克林霉素耐药率低（分别为1.3%、1.0%和2.3%）。与2018年和2019年相比，2014年对磷霉素的易感性显著降低，除此之外，金黄色葡萄球菌分离株的耐药性在这些年之间没有发现显著差异。MRSA和MSSA引起的HCAI的基线特征和死亡率相似。金黄色葡萄球菌引起的HCAI死亡率为6.5%（20例）。在多变量分析中，恶性肿瘤是与死亡率相关的独立危险因素（OR 5.446，95%CI 1.573-18.849）。我们的研究结果表明，MSSA仍然是金黄色葡萄球菌引起的HCAI的主要病原体。死亡率为6.5%，对青霉素的抗生素耐药性很高，恶性肿瘤的诊断是增加儿童死亡率的主要危险因素。这些发现可能有助于改善儿童金黄色葡萄球菌引起的HCAI的管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.