Clinical characteristics and resistance patterns of Staphylococcus aureus infections in children at a tertiary care hospital in southern Turkey

Purpose: The aim of this study was to evaluate the clinical and demographic characteristics and resistance patterns to antistaphylococcal antibiotics of Staphylococcus aureus (S. aureus) isolates, which is a leading cause of invasive infections in children. Materials and Methods: Patients who were under 18 years of age and who had S. aureus growth in abscess, wound, blood, cerebrospinal fluid, joint fluid and any other sterile body fluid cultures, who were followed up at Children’s Health and Diseases Clinic in between July 2018 and July 2020 were included in the study. Results: A total of 135 patients and cultures were included in the study. Community-acquired S. aureus (CA-SA) infection was present in 105 (77.7%) patients and hospital-acquired S. aureus (HA-SA) infections in 30 (22.3%). S. aureus was most commonly detected in skin and soft tissue infections. Skin and soft tissue infections were more common in patients with community-acquired disease, whereas bacteremia was more common in patients with nosocomial infection. Methicillin-resistant S. aureus (MRSA) isolates was encountered in 53.3% of all patients; Clindamycin resistance was found in 20% of all staphylococcal isolates and the ratio of mupirocin resistance was 14.4%.55.8% of all CA-SA and 46.7% of all HA-SA isolates were MRSA. Penicillin, mupirocin, erythromycin, and tetracycline resistance were significantly higher in MRSA isolates as compares to non-MRSA isolates. Mupirocin resistance was significantly higher in CA-SA isolates. The median length of hospital stay was 12 days. Length of hospital stay, duration of intravenous antibiotics use, mortality, and clindamycin resistance were significantly higher in patients with HA-MRSA infections. While overall mortality was 2.2% in patients with S. aureus infections, when evaluated separately, it was 10% in patients with HA-SA infections. Conclusion: Our CA-MRSA rates are quite high as compared to other reports, and clindamycin and mupirocin resistance seems to be an important problem in our region. Taking appropriate cultures at the right time is important in determining resistance patterns and guiding empirical treatment regimens.