Invasive community-acquired Staphylococcus aureus among pediatric population of Eastern Iran

BACKGROUND AND OBJECTIVE: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly reported worldwide. We aimed to determine the frequency of invasive CA-MRSA in children admitted to the pediatric wards of Imam Reza and Ghaem hospitals of Mashhad, Iran. MATERIALS AND METHODS: In this retrospective study, data regarding S. aureus isolates from pediatric patients’ sterile body sites (i.e. blood‚ joint, bone and lymph node aspiration) were retrieved in a time period from March 2006 to March 2012. Disc diffusion data was analyzed to determine the resistance pattern of the isolates, and differentiation between community-acquired and nosocomial S. aureus was done according to CDC guidelines. RESULTS: Twenty three invasive community-acquired S. aureus isolates from sterile body sites were identified, of which seventeen (74%) were CA-MRSA. The CA-MRSA isolates showed high frequency of resistance to non-β-lactam antibiotics (71% to erythromycin‚ 53% to co-trimoxazole, 44% to gentamicin and 36% to ciprofloxacin). CONCLUSION: In this study, the majority of invasive community-acquired S. aureus isolates were found to be CA-MRSA. Therefore, we recommend that primary treatment should be with antibiotics such as clindamycin, vancomycin, linezolid or daptomycin for any invasive infection suspected to be caused by S. aureus in these two hospitals.