Article in Japanese

Community-acquired invasive Staphylococcus aureus infections in children at a regional center in Kobe, Japan 1994-2019

Saki YAMADA¹⁾, Takayuki TAKEMOTO¹⁾, Kenichi ISOME¹⁾, Masayuki HORI¹⁾, Aya IWATA¹⁾, Kousaku MATSUBARA¹⁾

Background: Staphylococcus aureus is an important cause of infection in hospitalized children. However, data on the clinical characteristics of invasive S. aureus infections (ISAI) and proportion of methicillin-resistant S. aureu (MRSA), responsible for ISAI in Japan, are limited.
Methods: Patients with community-acquired ISAI were identified retrospectively between August 1994 and March 2019 at Kobe City Nishi-Kobe Medical Center; a regional center. ISAI patients were defined as those in whom S. aureus was isolated from a sterile site. The study period was divided into 4 periods: period 1 (August 1994-2000), period 2 (2001-2006), period 3 (2007-2013), and period 4 (2014-March 2019).
Results: Thirty ISAI patients were identified. Most of them exhibited osteoarticular infection(n=18), followed by bacteremia without focus (n=3). Of these patients, 24 and 6 were infected by methicillin-sensitive S. aureus and MRSA, respectively. The number of patients increased throughout the study period: 4 in period 1, 5 in period 2, 10 in period 3, and 11 in period 4. The number in the first 2 periods was significantly greater than that in the latter 2 (p<0.01). This significant difference was also observed (p=0.049) when the patient number was adjusted by the inpatient number. MRSA patients were identified during periods 1 to 3, but not during period 4. Nine patients (30%) had atopic dermatitis as an underlying condition.
Conclusion: The incidence of community-acquired ISAI increased over a 25-year study period, whereas MRSA infections have decreased in the recent 6 years. Atopic dermatitis may be a risk factor for ISAI in children.

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1) Department of Pediatrics, Kobe City Nishi-Kobe Medical Center

Key words	Staphylococcus aureus, community-acquired, invasive bacterial infection, child, methicillin-resistant Staphylococcus aureus
Received	July 10, 2019
Accepted	October 10, 2019

32 (1)：3─10,2020