Research On Clinical Features,Drug Resistance And Influence Factors Of Methicillin-Resistant Staphylococcus Aureus(MRSA) Cases Among Children

Objective To analyze the clinical characteristics and drug resistant between the cases of Methicillin-Resistant Staphylococcus Aureus（MRSA）and Methicillin Sensitive Staphylococcus Aureus（MSSA）.Explore the risk factors of MRSA infection,in order to provide the scientific basis for MRSA infection prevention.Methods A total number of 264 staphylococcus aureus confirmed infection cases were recruited from June 2014 to January 2016 in Anhui Provincial Children’s Hospital.The blood samples,pus samples,secretions,and sputum samples were collected according to the clinical symptoms of cases,and the antibiotic susceptibility test were preformed based on the recommended antibiotics according to the“National Practice for Clinical Examination(3^rd edition)”.Then,the cases were divided into two groups,which were149 MRSA cases,and 115 MSSA cases.The data of demographic characteristics,clinical test,C-reactive protein,infection position,and drug sensitive test were collected and compared in between two groups.The uncondit ional Logistic regression method was employed to explore the influence factors of MRSA infection.Results（1）The youngest MRSA cases was one month,while the oldest was 168months,and the median age was 11.0 months.The youngest MSSA cases was one month,while the oldest was 132 months,and the me dian age was 13.0 months.There were 54.4%（81/149）male cases in MRSA group,while 60.9%（70/115）of male cases in MSSA group.No obviously difference were observed of age（=0.978,P=0.613）and gender（=1.123,P=0.289）between MRSA group and MSSA group.The median days of MRSA group was 11.0 days,while 8.0 days of MSSA groups.The hospitalization days（H=4.983,P=0.026）MRSA group was significant higher than MSSA group.（2）The median CRP value was 27.6 mg/L of MRSA group,while MSSA group was 10.8 mg/L,there was a significant different between MRSA group and MSSA group.（3）A significant different of septicemia（=8.135,P<0.001）and respiratory infection（=6.235,P=0.013）between MRSA group and MSSA group were observed.（4）The results of resistance analysis showed that there were significant different of ampicillin（=92.091,P<0.001）,amoxycillin-clavulanic acid（=109.457,P<0.001）,ceftriaxone（=44.419,P<0.001）,clindamycin（=28.924,P<0.001）,erythromycin（=26.034,P<0.001）,levofloxacin（=6.287,P=0.012）,trimethoprim/sulfamethoxazole（=5.102,P=0.024）and tetracycline（=9.089,P<0.001）between MRSA group and MSSA group.（5）CRP（OR=1.008,OR95%CI:1.002-1.013）and respiratory infection（OR=3.429,OR95%CI:1.230-9.561）were the risk factors of MRSA.Conclusion The clinical features of children including length of stay,CRP value,septicemia,respiratory infection and drug resistance in MRSA group were significantly higher than the MSSA group,and the CRP value,and respiratory infection were the risk factors of MRSA.