Characterization of Staphylococcus aureus infections in children with Down syndrome. Issue 11 (November 2015)

• Record Type: Journal Article
• Authors: Johnston, Jeffrey N.; Kaplan, Sheldon L.; Mason, Edward O.; Hulten, Kristina G.
• Is Part Of: Journal of infection and chemotherapy. Volume 21:Issue 11(2015:Nov.)
• Page Start: 790
• Page End: 794
• Publication Date: 2015-11
• Subjects: Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2015.08.002
• Languages: English
• ISSNs: 1341-321X

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <p id="abspara0010"> <italic>Staphylococcus aureus</italic> infections in the Down syndrome (DS) population have not been well characterized. This study determined clinical and molecular characteristics of <italic>S. aureus</italic> infections in children with DS followed at Texas Children's Hospital (TCH), from 2001 to 2011.</p> <p id="abspara0015">Patients were retrospectively identified from an ongoing <italic>S. aureus</italic> surveillance study. Medical records were reviewed. Isolates were characterized by antimicrobial susceptibility, pulsed-field gel electrophoresis patterns, and detection of PVL genes (<italic>pvl</italic>), <italic>mup</italic>A (high-level mupirocin resistance gene), <italic>smr</italic> (chlorhexidine resistance conferring gene), and Staphylococcal Chromosomal Cassette <italic>mec</italic> (SCC<italic>mec</italic>) type. Twenty-six patients with DS had a total of 34 <italic>S. aureus</italic> infections (8 recurrent); 61% were MRSA. DS patients represented 16.8 per 10, 000 community onset <italic>S. aureus</italic> infections seen at TCH. Among 26 initial infections 17 were skin and soft tissue (SSTI), 7 were outer or middle ear and 2 were invasive infections. Seventeen patients were hospitalized. Thirteen (65%) of 20 available isolates were USA300, 14 were <italic>pvl</italic>+, 5 were <italic>mupA</italic>+, and 8 were <italic>smr</italic>+. Five of 8 (63%) recurrent infections were ear infections. All 4 recurrent ear isolates available for study were <italic>smr</italic>+, ciprofloxacin non-susceptible and treated with ciprofloxacin otic drops. <italic>S. aureus</italic> infections among patients with DS were similar in presentation to other patient groups, except for a greater proportion being associated with ear infections. Seventy percent of ear fluid isolates carried antiseptic and fluoroquinolone resistance genes. A study of a greater number of DS patients is warranted to further explore these findings.</p> </sec> </abstract>