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Archivos de Pediatría del Uruguay

Print version ISSN 0004-0584On-line version ISSN 1688-1249

Abstract

MAS, Mariana et al. Outpatient skin and soft tissue infections treated in a pediatric hospital in Uruguay after 10 years of MRSA epidemic. Arch. Pediatr. Urug. [online]. 2018, vol.89, n.4, pp.251-256. ISSN 0004-0584.  http://dx.doi.org/10.31134/ap.89.4.4.

There was an outbreak of community-acquired methicillin-resistant staphylococcus aureus (MRSA) in Uruguay in 2001. The identified germs found in skin and soft tissue infections (S and ST) varied, and reached 60%. Recent studies in Uruguay have shown changes in the types of infections acquired by hospitalized children.

Objective:

to determine MRSA prevalence and susceptibility to antibiotics in outpatient children .

Methodology:

a descriptive prospective study. Target: outpatient children consulting at ER for S and ST lesions who received germ isolation. Telephone follow-up after 72 hours. Time period : from December 10th 2015 to March 31st, 2016.

Results:

S and ST appointments: 797 (7 % of the total). Ambulatory visits: 691. Outpatients with identified etiologic agent: 194. Females: 102, mean and median age: 4 years of age. More frequent diagnosis: impetigo 181/194 (93%) Etiology: SA 152(MSSA 151, MRSA 1), beta hemolytic streptococci: BHGA 3, BHGB 3, coinfections 32 (16%), others 4. 32 of coinfections were MSSA plus another agent. Treatment with antibiotics: 99 received topical plus oral treatment, 54 received topical treatment, 21 received oral treatment, 20 received treatment that did not include antibiotics . Follow-up: 166 patients (86%). Good evolution: 165, repeated appointments: 5, hospitalized: none.

Conclusions:

Single SA or associated SA continues to be the main agent of S and ST infections that receive outpatient treatment. MRSA was responsible for 47% of ambulatory staphylococcal infections in the previous study. MRSA represents 0.6 (p»0.05) in this series. Continuous surveillance has enabled us to reassess the initial empirical epidemiological treatment and to change it if necessary.

Keywords : Infectious skin diseases; Staphylococcal infections; Methicillin resistant Staphylococcus aureus; Impetigo.

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