Work

Community acquired pediatric pneumonia due to methicillin resistant and methicillin susceptible Staphylococcus aureus in Ethiopia during 2016-2017

Year: 2018

Type: article

Abstract: Background: Although Staphylococcus aureus is known to cause a wide range of infections, it is a relatively uncommon cause of community acquired pneumonia (CAP), believed to be responsible for only 3-5% of the cases. With the emergence of community acquired (CA) methicillin-resistant S. aureus (MRSA), there is an increase in the number of reported severe community acquired S. aureus infections. The aim of the study was to determine the prevalence, antimicrobial susceptibility pattern, length of stay and clinical outcome of patients with S. aureus CAP. Methods & Materials: A prospective observational study was performed in two hospitals in Addis Ababa, Ethiopia from September 2016 to September 2017. All consecutive children between the ages of 0-15 yrs admitted with CAP were enrolled. S. aureus CAP was determined based on clinical signs and symptoms and blood culture positivity. S. aureus isolates were identified based hemolysis on blood agar, growth on mannitol salt agar, gram stain, coagulase test and Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Sensitivity testing was performed for 10 antibiotics including cefoxitin and mecA and femA genes were detected by PCR. Results: S. aureus could be isolated from 9 out of 557 children (1.6%) hospitalized with CAP. The mean age of children with S. aureus CAP was 6.18 ± 4.61months. Out of the 9 S. aureus isolates, 3 were MRSA. All isolates were resistant to penicillin, 5 to tetracycline, 3 to erythromycin, 2 to gentamicin and 1 each to clindamycin, ciprofloxacin, nitrofurantoin and trimethoprim-sulfamethoxazole. Except one child who had coronary heart disease and Down syndrome and the longest stay in hospital (32 days), the rest of the children had no comorbidities. The mean duration of stay in hospital was 8.1 ± 10.7 days. All children were treated with antibiotics and improved. Conclusion: The study shows that S. aureus is an uncommon but significant cause of community acquired pneumonia in Ethiopian children and indicates the emergence of MRSA as a cause of community acquired pneumonia and an increasing resistance of S. aureus to tetracycline, erythromycin and gentamicin.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2018.04.4165