WASHINGTON — A clonal outbreak of community-acquired methicillin-resistant Staphylococcus aureus in Los Angeles County led to a high rate of hospitalizations among children in 2003, Elizabeth Bancroft, M.D., reported in a poster at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
Following skin infection outbreaks of MRSA (USA 300; ST:8) in 2002, community-acquired methicillin-resistant S. aureus (CAMRSA) infections in hospitalized children less than 18 years of age was made a reportable condition from May 5 to Nov. 7, 2003. A total of 140 cases were reported between those dates, said Dr. Bancroft of the Los Angeles County Department of Health Services.
Mean age of the children was 6.25 years (range 0-17), 51% were female, 66% were Hispanic, 16% white, 15% black, and the remainder said they were “other.” Their mean length of stay was 5.13 days (range 1-30). Diagnoses included cellulitis in 44%, abscess in 36%, and a combination of the two in 11%.
Prior misdiagnosis as insect or spider bites occurred in 23%, and 75% of those who had been treated with antibiotics were initially treated inappropriately with β-lactams, she said.
Among 82 for whom a caregiver was interviewed, 24 (29%) had household contact with a skin infection within a month of the child's infection. Other nosocomial risk factors were present in 29 (35%), while risk factors for community-acquired infection were present in 38 (46%), including 9 (11%) who had contact with a recently incarcerated person.
Of 83 isolates analyzed, 79 (96%) were consistent with the USA 300; ST:8 CAMRSA genotype, even though many of the children had nosocomial risk factors.