International Journal of Medical and Health Research

ISSN: 2454-9142

Vol. 3, Issue 7 (2017)

Culture positive staphylococcus aureus infection in children admitted in a tertiary care hospital: a case series

Author(s): Dr. NR Sutay, Dr. Devanand Choudhari, Dr. Vikas, Dr. Manish Tiwari
Abstract: Introduction: Staphylococcus aureus is one of the common organisms causing invasive disease in pediatric age group especially in communities where widespread vaccination against streptococcus pneumonia and H. Influenzae have reduced the incidence of serious infections caused by these organisms. S. Aureus is frequently implicated in hospital acquired infections and neonates and infants are most vulnerable for these infections because of quantitative and qualitative immaturity of innate immunity. Other risk factors for staphylococcal sepsis include central lines, total parenteral nutrition, cystic fibrosis, babies receiving immunosuppression or steroid therapy. With the emergence of methicillin resistant staphylococcus aureus this infection has become a serious healthcare problem in pediatric age group. Despite being an important cause of morbidity and mortality in pediatric age group only few population-based studies of culture positive Staphylococcus aureus infection in children have been conducted.
Aims and Objectives: To describe the clinical features and presentations of cases of culture positive Staphylococcus aureus in children in a tertiary hospital over the period of one year.
Materials and Methods: Retrospective review of case notes of ten patients who were admitted over the period of 6 months with reference to laboratory confirmed culture positive Staphylococcus aureus infection. The presentation and clinical features were studied in detail. Special emphasis was given to cases infected with methicillin resistant staphylococcus aureus.
Inclusion criteria
(1) Children less than 10 years with culture positive staphylococcal infections.
(2) Documented culture and sensitivity patterns.
(3) Documented response to treatment.
Exclusion Criteria
(1) Children more than 10 years of age.
(2) Documented culture or sensitivity report not available.
Observations and Results: Ten children in between age group of 3 months to 10 years admitted in a tertiary care hospital with culture positive Staphylococcus aureus infections were studied in this case series. The culture sensitivity patterns were compared. Out of 10 culture positive reports 6 reports were suggestive of methicillin resistance staphylococcus aureus growth and 4 reports were suggestive of methicillin sensitive staphylococcus aureus growth. The mean age of presentation was three and half years (median three years). All patients presented with superficial or deep skin infections. 7/10 (70%) were apparently well and taking feeds properly. Four children presented with multiple abscesses of which one patient was a diagnosed case of chronic granulomatous disease, two were diagnosed with hyper IgE syndrome, one was nasal carrier of staphylococcus aureus, one with cellulitis, one with Ludwig’s angina, one patient had post- vaccination thigh abscess, one with pyopneumothorax and the remainder with abscess. Of these, one child presented with parotid abscess. Two had a personal history of recurrent skin infections or abscesses. None had close family members with a history of skin infections.
Conclusions: The incidence of culture positive staphylococcal infections is increasing in our hospital. These infections can be both MRSA and MSSA. Of concern is the fact that one of our patients presented with culture positive-SA infections within the first 3 month of life has MRSA growth in pus culture sensitivity.
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