23. Clinical, subclinical features and treatment of infection caused by Staphylococcus aureus in newborn
Main Article Content
Abstract
This study aimed to describe the clinical and subclinical features and treatment results of Staphylococcus aureus infection in newborns at the Neonatal Center, National Children's Hospital, from January 2022 to June 2023. Among the 108 children, 81.5% were born full-term, 77.8% weighed ≥ 2500g, and 88% were hospitalized after 3 days of age with symptoms of poor feeding (63.9%) and fever (65.7%). The lesions were mainly in the skin-soft tissue (58.3%), sepsis (35.2%) and pleural pneumonia (25%). 32.4% had leukocytes ≥ 20 g/L and 59.3% had a CRP ≥ 15 mg/L. The MRSA ratio was elevated (81.5%), with a MIC ≥ 1 μg/mL at 46.3%. The bacteria are completely sensitive to vancomycin and linezolid (100%). The average duration of treatment was 16.9 ± 11.6 days. 87.9% of patients were treated with vancomycin, 63.9% of cases requiredantibiotic combinations. Intervention for abscess incision reached 31.5% and pleural drainage was 14.8%. The mortality rate was 7.4%, mainly due to sepsis and necrotizing pneumonia. Optimizing diagnosis and treatment is essential to improve treatment outcomes and reduce serious complications.
Article Details
Keywords
Neonatal infections, Staphylococcus aureus, infants
References
2. Vasiljević B, Antonović O, Maglajlić-Djukić S, et al. [The serum level of C-reactive protein in neonatal sepsis]. Srp Arh Celok Lek. 2008; 136(5-6): 253-257. doi:10.2298/sarh0806253v.
3. Ortiz de Zárate M, Sáenz C, Cimbaro Canella R, et al. Prevalence of microbiologically confirmed neonatal sepsis at a maternity center in the City of Buenos Aires. Arch Argent Pediatr. 2023; 121(3): e202202779. doi:10.5546/aap.2022-02779.eng.
4. Ericson JE, Popoola VO, Smith PB, et al. Burden of Invasive Staphylococcus aureus Infections in Hospitalized Infants. JAMA Pediatr. 2015 Dec; 169(12): 1105-11. doi: 10.1001/jamapediatrics.2015.2380.
5. Sattler CA, Mason EO, Kaplan SL. Prospective comparison of risk factors and demographic and clinical characteristics of community-acquired, methicillin-resistant versus methicillin-susceptible Staphylococcus aureus infection in children. Pediatr Infect Dis J. 2002; 21(10): 910-917. doi:10.1097/00006454-200210000-00005.
6. Nguyễn Thị Quỳnh Nga (2020), Nhiễm khuẩn sơ sinh, Bài giảng Nhi khoa, Tập 1, Nhà xuất bản Y học, Trường Đại học Y Hà Nội, trang 119-129.
7. James S. Lewis II, PharmD, et al (2023), Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25. Wayne, PA - Z-Library.
8. Shadbolt R, We MLS, Kohan R, et al. Neonatal Staphylococcus Aureus Sepsis: a 20-year Western Australian experience. Journal of perinatology. 2022; 42(11): 1440-1445. doi:10.1038/s41372-022-01440-3.
9. Wu X, Wang C, He L, et al. Clinical characteristics and antibiotic resistance profile of invasive MRSA infections in newborn inpatients: a retrospective multicenter study from China. BMC pediatrics. 2023; 23:264. doi:10.1186/s12887-023-04084-0.
10. Đỗ Trọng Đạt. Đặc điểm lâm sàng, tính nhạy cảm kháng sinh của vi khuẩn và nhận xét kết quả điều trị nhiễm khuẩn huyết do tụ cầu vàng tại Bệnh viện Nhi trung ương, Luận văn Thạc sĩ y học, Trường Đại Học Y Hà Nội; 2020.
11. Qiao Y, Ning X, Chen Q, et al. Clinical and molecular characteristics of invasive community-acquired Staphylococcus aureusinfections in Chinese children. BMC infectious diseases. 2014; 14: 582. doi:10.1186/s12879-014-0582-4.
12. Celik IH, Hanna M, Canpolat FE, et al. Diagnosis of neonatal sepsis: the past, present and future. Pediatric research. 2022 Jan; 91(2): 337-350. doi: 10.1038/s41390-021-01696-z.
13. Miles F, Voss L, Segedin E, et al. Review of Staphylococcus aureus infections requiring admission to a paediatric intensive care unit. Archives of disease in childhood. 2005; 90(12): 1274-1278. doi:10.1136/adc.2005.074229.
14. Dong Q, Liu Y, Li W, et al. Phenotypic and Molecular Characteristics of Community-Associated Staphylococcus aureus Infection in Neonates. Infection and drug resistance. 2020; 13: 4589-4600. doi:10.2147/IDR.S284781.
15. Song KH, Kim M, Kim CJ, et al. Impact of Vancomycin MIC on Treatment Outcomes in Invasive Staphylococcus aureus Infections. Antimicrobial agents and chemotherapy. 2017; 61(3): e01845-16. doi:10.1128/AAC.01845-16.
16. Ricardo de Stefani Dalponte, Gabriel Cipriano Vidal Heluany and Monique Michels, et al. Tratamento cirúrgico de pneumonia necrosante em crianças em um período de 10 anos. Revista do Colégio Brasileiro de Cirurgiões. 2020. Vol. 47(1). doi: 10.1590/0100-6991e-20202374.
17. Sicot N, Khanafer N, Meyssonnier V, et al. Methicillin resistance is not a predictor of severity in community-acquired Staphylococcus aureus necrotizing pneumonia-results of a prospective observational study. Clinical Microbiology and Infection. 2013; 19(3): E142-E148. doi:10.1111/1469-0691.12022.
18. Khokhlova OE, Hung WC, Wan TW, et al. Healthcare- and Community-Associated Methicillin-Resistant Staphylococcus aureus (MRSA) and Fatal Pneumonia with Pediatric Deaths in Krasnoyarsk, Siberian Russia: Unique MRSA’s Multiple Virulence Factors, Genome, and Stepwise Evolution. PLoS One. 2015; 10(6): e0128017. doi:10.1371/journal.pone.0128017.