Background Over the past decade, the management of pediatric Staphylococcus aureus (SA) otorhinolaryngologic infections has become increasingly more challenging. There are few studies that have addressed this topic at the institutional level, and none that have assessed national trends in SA resistance patterns for pediatric otorhinolaryngologic infections. We hypothesize that there is an increasing national prevalence of pediatric otorhinolaryngologic infections caused by methicillin-resistant SA (MRSA).
Objective To evaluate the regional and national resistance patterns of pediatric otorhinolaryngologic SA infections.
Design 1) Prospective clinical and microbiologic analysis, 2) Database review
Methods Over a six-month period, culture specimens from pediatric patients with otorhinolaryngologic infections were prospectively assessed for the presence of SA. Patients with SA infections were divided into two groups based on the sensitivities of their cultured organism. Institutional data were compared to a national microbiology database, in order to assess for trends in SA resistance.
Results Seventy-seven cultures were positive for SA. Forty-three (56%) were MRSA. In our study group, patients with MRSA deep neck infections had a more virulent clinical course compared to those with sensitive strains. In the United States, MRSA accounted for 21.5% of 21,009 pediatric otorhinolaryngologic SA cultures.
Conclusion This study points out an alarmingly high prevalence of MRSA in pediatric otorhinolaryngologic infections in our major metropolitan center, as well as throughout the United States. Patients with MRSA deep neck space infections seem to follow a more virulent clinical course. Further studies are needed to elucidate the microbiologic virulence factors responsible for this pattern.
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