Pediatr Infect Dis J. 2025 Jun 3. doi: 10.1097/INF.0000000000004860. Online ahead of print.
ABSTRACT
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant public health threat, causing skin and soft tissue infections (SSTIs) and severe complications in children. Virulence factors such as Panton-Valentine leucocidin (PVL) enhance its pathogenicity. This study investigates the epidemiology, antibiotic resistance and PVL production of community-acquired MRSA (CA-MRSA) infections among children.
METHODS: A nationwide multicenter retrospective study was conducted on children under 18 years diagnosed with CA-MRSA infections in Spain between 2018 and 2020. Positive MRSA cultures were obtained from biological samples within the first 48 hours of hospital or primary care contact and analyzed for antibiotic susceptibility and PVL production. Epidemiological, clinical and microbiological data were described and compared with previous colonization data. Statistical analyses, including multivariate logistic regression, were performed to identify factors associated with infection.
RESULTS: A total of 252 children with CA-MRSA infections were included, with a median age of 5.5 years (interquartile ranges: 2-10). SSTIs accounted for 89.3% of cases, and 23.6% required hospitalization. Migrant status (52.5%) and prior SSTIs (39.1%) were significantly associated with MRSA infection (P < 0.05). MRSA strains causing infection exhibited high resistance to ciprofloxacin (32.2%) and clindamycin (18.3%). No differences in antibiotic susceptibility were observed between strains causing infection and colonization. Reinfection occurred in 21% of cases, despite 45.3% undergoing decolonization. PVL genes were detected in 76.9% of MRSA strains, and were significantly more frequent in infection compared to colonization (P < 0.001).
CONCLUSIONS: Migrant status and PVL toxin production are significant risk factors for MRSA infections. The high prevalence of antibiotic resistance highlights the importance of tailoring empirical treatment strategies based on local resistance patterns.
PMID:40472240 | DOI:10.1097/INF.0000000000004860
