Geographic distribution of community-acquired methicillin-resistant Staphylococcus aureus soft tissue infections

• Published in: Journal of pediatric surgery Vol. 46; no. 6; pp. 1089 - 1092
• Main Authors: Rossini, Connie J, Moriarty, Kevin P, Tashjian, David B, Garb, Jane L, Wait, Richard B
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2011
• Subjects: Adolescent; Age Distribution; Anti-Bacterial Agents - therapeutic use; Child; Child, Preschool; Cohort Studies; Community-Acquired Infections - drug therapy; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Female; Follow-Up Studies; Humans; Incidence; Infant; Infant, Newborn; Male; Methicillin resistance; Methicillin-Resistant Staphylococcus aureus - drug effects; Methicillin-Resistant Staphylococcus aureus - isolation & purification; MRSA; Pediatric community-acquired infections; Pediatrics; Residence Characteristics; Retrospective Studies; Severity of Illness Index; Sex Distribution; Soft Tissue Infections - drug therapy; Soft Tissue Infections - epidemiology; Soft Tissue Infections - microbiology; Soft Tissue Infections - physiopathology; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - epidemiology; Surgery; Treatment Outcome; United States - epidemiology; Young Adult; United States; Pediatric community-acquired infections; Methicillin resistance; MRSA
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2011.03.036

Abstract Purpose The goal of this study is to look at the geographic growth patterns of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in our local region and to determine if specific geographic areas are at increased risk. Methods After Institution Review Board approval (132603-3), a retrospective chart review was conducted of 614 patients who underwent incision and drainage of an abscess by a single pediatric surgical practice from January 2004 to December 2008. In addition, previously published data from 195 patients who underwent incision and drainage of an abscess from January 2000 to December 2003 were reviewed. Results The most commonly cultured organism found in the pediatric population undergoing incision and drainage was S aureus (n = 388), of which 258 (66%) were methicillin resistant. This is a 21% increase from the rate of MRSA cultures identified from 2000 to 2003. Geographic information system space-time analysis showed that a cluster of 14 MRSA cases was located within a 1.44-km radius between 2000 and 2003, and 5 separate clusters of more than 20 MRSA infection cases each were identified in 3 separate cities over the 8-year time span using geographic information system spatial analysis ( P value = .001). Conclusion Methicillin-resistant S aureus has now become the most prevalent organism isolated from cultures of community-acquired abscesses requiring incision and drainage in the pediatric population in our local region. Significant clustering of MRSA infections has appeared in several different cities within our geographic region.