Gülsüm ALKAN, Hatice TÜRK DAĞI, Melike EMİROĞLU, Rumeysa İPTEŞ, Şadiye Kübra TÜTER ÖZ, Meltem KIYMAZ, Muslu Kazım KÖREZ

Çocuklarda Staphylococcus aureus Enfeksiyonlarının Değerlendirilmesi

Amaç: Staphylococcus aureus, dünya çapında morbidite ve mortaliteye yol açan en yaygın enfeksiyöz ajanlardandır. Toplumdan ve hastaneden edinilen enfeksiyonlar cilt enfeksiyonlarından hayatı tehdit eden enfeksiyonlara kadar değişebilmektedir. S. aureus enfeksiyonlarının tedavisi, antibiyotik direnci ve aşı eksikliği nedeniyle zordur. Çalışmamızda S. aureus enfeksiyonu olan çocukların demografik, klinik ve laboratuvar parametrelerini ve prognozunu değerlendirmeyi amaçladık. Yöntem: Selçuk Üniversitesi Tıp Fakültesi Çocuk Enfeksiyon Hastalıkları Bölümünde 2014-2022 yılları arasında, S.aureus ile enfekte çocuklar retrospektif olarak analiz edildi. Hastalar MRSA, MSSA ve toplumdan veya hastane kaynaklı enfeksiyonlar açısından değerlendirildi. Bulgular: Toplam 116 çocuk örneğinin %31,9'u MRSA ve %68,1'i MSSA idi. Toplum kökenli (TK) enfeksiyonlar %88,8 iken, hastane kaynaklı (HK) enfeksiyonların oranı %11,2 idi. MSSA, TK enfeksiyonda daha yaygınken, MRSA ise HK enfeksiyonda daha yaygındı (p=.025). En sık klinik belirtiler yumuşak doku enfeksiyonu, lenfadenit, cilt enfeksiyonu, osteomiyelit ve septik artritti. Her hastaya antibiyotik tedavisi uygulandı, hastaların %77.59'unun hastaneye yatırılması gerekti. Hastaların %62,9'una cerrahi girişim (drenaj ve debridman) uygulandı. Hastaların %86.2'sinin iyileşmesine rağmen, epidermolizis bülloza, CIPA sendromu veya kemik implantları olan dokuz hastada tekrarlayan enfeksiyonlar saptandı. Şant menenjiti olan bir hasta öldü. Sonuç: S. aureus, çocuklarda hem toplumdan hem de hastane kaynaklı yüzeysel veya invaziv enfeksiyonlara neden olmaktadır. Özellikle yaşamı tehdit eden enfeksiyonlarda, antibiyogram kültür sonucu çıkıncaya kadar uygun antibiyotik tedavisi mortalitenin önlenmesi açısından kritik öneme sahiptir. Ampirik antibiyotik başlanırken hastanın klinik durumu ve bölgesel antibiyotik direnci göz önünde bulundurulmalıdır.

Anahtar Kelimeler:

Çocuk, invaziv enfeksiyonlar, Staphylococcus aureus, deri ve yumuşak doku enfeksiyonları

Evaluation of Staphylococcus aureus Infections in Children

Aim: Staphylococcus aureus is the most common infectious agent worldwide which leads to morbidity and mortality. Community and hospital acquired infections can range to skin infections to life-threatening infections. In our study, we attempted to evaluate demographic, clinical, and laboratory parameters and the prognosis of children with S. aureus infection. Methods: Children infected with S. aureus at the Department of Paediatric Infectious Disease, Selcuk University Faculty of Medicine, from 2014 to 2022 were analysed retrospectively. Patients were evaluated for MRSA, MSSA, and community or hospital-acquired infections. Results: A total of 116 children's detected specimens were collected; 31.9% contained MRSA and 68.1% contained MSSA. The proportion of community-acquired (CA) infections was 88.8%, while hospital-acquired (HA) infections were 11.2%. MSSA was more common in the CA-S. aureus group, while MRSA was more common in the HA-S. aureus group (p=.025). The most common clinical manifestations included soft tissue infection, lymphadenitis, cutaneous infection, osteomyelitis, and septic arthritis. Each patient was treated with antibiotics, 77.59% of patients was required hospitalization. In 62.9% of the patients, surgical intervention (drainage or debridement) was performed. Despite 86.2% of the patients were cured, infection persisted in nine patients with epidermolysis bullosa, CIPA syndrome, and bone implants. One patient with shunt meningitis died. Conclusions: S. aureus cause both CA and HA superficial or invasive infections, in children. Especially in life-threatening infections, appropriate antibiotic therapy is critical for preventing mortality until an antibiogram culture result is obtained. The patient's clinical condition and regional antibiotic resistance should be considered when prescribing antibiotics empirically.

Keywords:

Child, invasive infections, Staphylococcus aureus, skin and soft tissue infections,

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