[Prevalence and risk factors for methicillin-resistant Staphylococcus aureus infection in children]. / Prevalencia y factores de riesgo de infección por Staphylococcus aureus resistente a meticilina en niños.

OBJECTIVE: The objectives of this work were to know the prevalence of methicillin-resistant S. aureus (MRSA) infections in the paediatric population of our health department, to describe the risk factors for infection by MRSA compared to those produced by methicillin-susceptible S. aureus (MSSA) and to know the antibiotic sensitivity profile of MRSA and MSSA isolates. METHODS: A retrospective, descriptive and analytical study of infections produced by MRSA versus those produced by MSSA was carried out during the years 2014 to 2018. Risk factors for MRSA infection were studied using a binary logistic regression model. RESULTS: 162 patients with S. aureus infections were identified. Of these, 25 (15.4%) were MRSA. The highest percentages of MRSA infection occurred among children who required hospital admission (23.4%). In the univariate analysis the need of hospital admission, antibiotic treatment in the last 3 months, the kind of infection and past MRSA infection or colonisation reached statistical significance. However, only the need of hospital admission and antibiotic treatment in the last 3 months maintained statistical significance in the binary logistic regression model. Correct antibiotic treatment was only prescribed in 26.7% of the MRSA infection cases admitted to the hospital. CONCLUSIONS: Our results suggest the need to review empirical local treatment regimen using drugs active against MRSA in infections of probable staphylococcal origin admitted to the hospital, especially if they have received antibiotic treatment in the last 3 months.

[Estimation of incidence and analysis of sepsis in an area of Valencia (Spain)]. / Incidencia estimada y análisis de la sepsis en un área de Valencia.

OBJECTIVES: To study the incidence of sepsis in an area of Valencia, as well as its characteristics, and to evaluate short-term outcomes. PATIENTS AND METHODS: An active surveillance program was carried out to determine the incidence and characteristics of sepsis. All patients attending the Hospital de La Ribera from January 1999 to December 2004 were included. Incidence rates were calculated and logistic regression analysis was performed. RESULTS: The incidence rate was 60.9 per 100,000 person-years. The incidence was highest among children younger than 1 year (1,138 per 100,000 person-years). A total of 14.4 % of cases were nosocomial infections. The most common microorganisms found were Escherichia coli, Streptococcus pneumoniae and Neisseria meningitidis. Microbiologically undocumented sepsis accounted for 32 % of the cases. The case-fatality rate was 1.3 %. Seventeen patients (11.1 %) were transferred to an intensive care unit (ICU). The risk of being transferred to an ICU was 14 times higher in patients with meningitis than in those with other sources of infection, independently of age and microbiological characteristics (OR 13.9, 95 % CI 2.6-75.3, P = 0.002). CONCLUSIONS: The incidence rate of sepsis is high in the pediatric age group. Clinical sepsis represented an important percentage of pediatric sepsis in our center. The main factor associated with patient transfer to the ICU was the central nervous system as the source of sepsis.

Incidencia estimada y análisis de la sepsis en un área de Valencia / Estimation of incidence and analysis of sepsis in an area of Valencia (Spain)

Objetivos. Estudiar la incidencia de sepsis en un área de Valencia, conocer las características de los casos y evaluar su evolución a corto plazo. Pacientes y métodos. Se desarrolló un programa de vigilancia epidemiológica activo para determinar la incidencia de sepsis y conocer sus características. Se consideró caso todo paciente que acudió al Hospital de La Ribera desde enero de 1999 a diciembre de 2004. Se calculó la densidad de incidencia y se realizó un análisis de regresión logística. Resultados. La densidad de incidencia fue 60,9 por 100.000 persona-años. La mayor incidencia se observó en los menores de un año (1.138 por 100.000 persona-años). El 14,4 % de los casos correspondieron a infecciones nosocomiales. Los microorganismos aislados más frecuentemente fueron Escherichia coli, Streptococcus pneumoniae y Neisseria meningitidis. La sepsis no documentada microbiológicamente correspondió al 32 % de los casos. La letalidad fue del 1,3 %. Se trasladaron a una unidad de cuidados intensivos (UCI) 17 casos (11,1 %). Los casos de meningitis tuvieron 14 veces más probabilidades de ser trasladados a una UCI que los casos cuyo foco de la infección tuvo otra localización, independientemente de la edad y de las características microbiológicas (odds ratio: 13,9; intervalo de confianza del 95 %: 2,6-75,3; p = >0,002). Conclusiones. La sepsis en pediatría tiene una incidencia elevada. La sepsis clínica representó un porcentaje importante de los casos. El principal factor asociado al traslado de los pacientes a la UCI fue la sepsis con origen en el sistema nervioso central

Objectives. To study the incidence of sepsis in an area of Valencia, as well as its characteristics, and to evaluate short-term outcomes. Patients and methods. An active surveillance program was carried out to determine the incidence and characteristics of sepsis. All patients attending the Hospital de La Ribera from January 1999 to December 2004 were included. Incidence rates were calculated and logistic regression analysis was performed. Results. The incidence rate was 60.9 per 100,000 person-years. The incidence was highest among children younger than 1 year (1,138 per 100,000 person-years). A total of 14.4 % of cases were nosocomial infections. The most common microorganisms found were Escherichia coli, Streptococcus pneumoniae and Neisseria meningitidis. Microbiologically undocumented sepsis accounted for 32 % of the cases. The case-fatality rate was 1.3 %. Seventeen patients (11.1 %) were transferred to an intensive care unit (ICU). The risk of being transferred to an ICU was 14 times higher in patients with meningitis than in those with other sources of infection, independently of age and microbiological characteristics (OR 13.9, 95 % CI 2.6-75.3, P = 0.002). Conclusions. The incidence rate of sepsis is high in the pediatric age group. Clinical sepsis represented an important percentage of pediatric sepsis in our center. The main factor associated with patient transfer to the ICU was the central nervous system as the source of sepsis