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Staphylococcus aureus Infections in Pediatric Oncology Patients: High Rates of Antimicrobial Resistance, Antiseptic Tolerance and Complications.
MedLine Citation:
PMID:  22976051     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Patients with malignancies represent a population at high risk for drug resistant infections. We sought to determine the clinical spectrum and molecular epidemiology of S. aureus infections in pediatric oncology patients followed at Texas Children's Hospital (TCH). Furthermore, we determined the prevalence of the chlorhexidine resistance gene qacA/B from isolates in this unique population. METHODS:: Patients with a history of malignancy and a culture proven S. aureus infection were identified from 2001-2011. Antibiotic susceptibility, pulsed-field gel electrophoresis and detection of qacA/B by PCR were carried out on all isolates. Medical records for all patients were reviewed. RESULTS:: During the study period, 213 isolates were identified from 179 patients with malignancies. Thirty-one percent of the isolates were MRSA. The most common infectious diagnosis was bacteremia [85/213 (39.9%), with 72/85 (84.7%) being catheter-associated]. Thirteen patients with bacteremia were found to have pulmonary nodules at the time of presentation; only S. aureus was found in tissue in 5/6 patients who underwent lung biopsy. After 2007, 18.2% of isolates were qacA/B positive with a steady increase in prevalence every year (chi square for trend p value=0.04). CONCLUSIONS:: S. aureus is a significant cause of morbidity and mortality in pediatric oncology patients at TCH. In addition to the more well-known clinical manifestations, this pathogen can also be associated with pulmonary nodules. Furthermore, the prevalence of S. aureus isolates carrying antiseptic resistance genes increased in this population. Additional clinical and molecular studies and surveillance among pediatric oncology patients are warranted to further explore these findings.
Authors:
J Chase McNeil; Kristina G Hulten; Sheldon L Kaplan; Donald H Mahoney; Edward O Mason
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-11
Journal Detail:
Title:  The Pediatric infectious disease journal     Volume:  -     ISSN:  1532-0987     ISO Abbreviation:  Pediatr. Infect. Dis. J.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701858     Medline TA:  Pediatr Infect Dis J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics, Sections of Infectious Diseases 1and Hematology-Oncology 2Baylor College of Medicine, Houston, Texas.
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