Documentation of vancomycin-resistant Staphylococcus aureus (VRSA) among children with atopic dermatitis in the Qassim region, Saudi Arabia.

Sept 2012

Alzolibani AA, Al Robaee AA, Al Shobaili HA, Bilal JA, Issa Ahmad M, Bin Saif G.

Source

Department of Dermatology, College of Medicine, Qassim University, Buraydah 51477, Saudi Arabia. azolibani@yahoo.com.

Abstract

INTRODUCTION:

Staphylococcus aureus is known as a common pathogen in atopic dermatitis. A methicillin-resistant S. aureus strain with reduced susceptibility to vancomycin (VISA/VRSA) is increasing worldwide. The aims of this study were to evaluate the antibiotic-susceptibility pattern of S. aureus isolated from children with atopic dermatitis and to identify the occurrence of resistance to glycopeptide antibiotics.

METHODS:

Swabs were collected from atopic dermatitis skin lesions of 80 children being treated at dermatology clinics whose ages ranged from 6 months to 15 years in the period from March 2009 to February 2010. Isolates were studied with an antibiogram for an antibiotic-susceptibility test. The selected antibiotics were the usually administered antimicrobials at dermatological clinics in Buraydah (Qassim, Saudi Arabia). Results were determined as minimal inhibitory concentration (MIC) using the Vitek system.

RESULTS:

Thirty S. aureus isolates showed resistance to streptomycin (100%), benzylpenicillin and ampicillin (96.7%), and oxacillin (90%). S. aureus resistance to trimethoprim/sulfamethoxazole, tigecycline, and vancomycin was 63.3%, 83.3%, and 53.3%, respectively. Resistance to linezolid was less, at 5.7%.

CONCLUSIONS:

Strains of MRSA with decreasing susceptibility to vancomycin were documented in the Qassim region of Saudi Arabia. Other studies will be required on VISA/VRSA strains concerning phenotypic and genotypic characterization.

PubMed

Oral and topical antibiotic prescriptions for children in general practice.

Dec 2012

de Bont EG, van Loo IH, Dukers-Muijrers NH, Hoebe CJ, Bruggeman CA, Dinant GJ, Cals JW.

Source

Department of General Practice, Maastricht University, , Maastricht, Limburg, The Netherlands.

Abstract

OBJECTIVE:

 Most primary care clinical guidelines recommend restrictive antibiotic use for childhood infections. We investigated antibiotic prescription rates over time for oral and topical antibiotics for children (≤12 years) in the period 2000-2010.

DESIGN, SETTING AND PATIENTS:

Longitudinal observational study among children (≤12 years) in a large Dutch general practice database in the period 2000-2010.

MAIN OUTCOME MEASURES:

Oral and topical antibiotic prescribing rates per year and independent factors influencing antibiotic prescriptions.

RESULTS:

 We analysed 108 555 patient-years during 2000-2010. At least one chronic disease was recorded in 15.8% of patient-years, with asthma most commonly registered. In 14.8% of the patient-years at least one antibiotic was prescribed, while 26.3% of these received two or more prescriptions. Young age and chronic disease had a significant effect on antibiotic prescriptions. Prescriptions for oral and topical antibiotics increased 4.9% and 1.8%, respectively, during 2000-2005. Prescription rates for oral antibiotics decreased 3.3% during 2006-2010, while topical prescribing rates remained stable.

CONCLUSIONS:

 One in six children received at least one oral antibiotic prescription per year during 2000-2010. While topical prescription rates steadily increased during 2005-2010 and remained stable during 2006-2010, prescription rates for oral antibiotics increased significantly during the period 2000-2005 and then significantly decreased during the period 2006-2010. As clinical guidelines remained the same over this period, the effects could be contributed to the initiation of the Dutch nationwide pneumococcal vaccination campaign in 2006.

PubMed

Pediatric musculoskeletal infection: trends and antibiotic recommendations.

Pediatric musculoskeletal infection: trends and antibiotic

recommendations

J Am Acad Orthop Surg. 2009 Oct

Copley LA.

Dr. Copley is Assistant Professor of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX.

Neither Dr. Copley nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution directly or indirectly related to the subject of this article.

In the past decade, the incidence of methicillin-resistant Staphylococcus aureus infections in children has increased. This phenomenon has led to a rise in complex, deep infections involving the musculoskeletal system for which a comprehensive approach of evaluation and treatment has become necessary. Whenever possible, cultures should be obtained to guide specific antibiotic selection. The potential for infections involving multiple tissue locations within the same patient and the risk for complications such as deep vein thrombosis necessitate a thorough, often multidisciplinary, approach in the care of these children. MRI is valuable in defining the anatomic and spatial extent of infection as well as in guiding the decision and approach for surgery. Most patients have favorable outcomes with sequential parenteral to oral antibiotic therapy after adequate surgical débridement of the infection. Close outpatient follow-up is essential to ensure antibiotic compliance and to identify late consequences of the infection.

American Academy of Orthopaedic Surgeons

National trends in emergency department antibiotic prescribing for children with acute otitis media, 1996 2005.

National trends in emergency department antibiotic prescribing for children with acute otitis media, 1996 2005.

Acad Emerg Med. 2007 Dec

Fischer T, Singer AJ, Lee C, Thode HC Jr.
Department of Emergency Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.

OBJECTIVES: Withholding antibiotics in nontoxic children with acute otitis media (AOM) is now recommended to reduce bacterial resistance rates. Using the National Hospital Ambulatory Medical Care Survey (NHAMCS), the authors describe the national trends for prescribing antibiotics in children with AOM presenting to emergency departments (EDs) in the United States over the past decade. The authors hypothesized that the rates of prescribing antibiotics would decline over time.

METHODS: This was a retrospective study of NHAMCS databases. A national sampling of ED visits for 1996-2005 was used to identify trends in ED prescription of antibiotics to patients with AOM. The National Drug Code Directory Drug Classes were used to identify type of antibiotic prescribed. Frequency and type of antibiotic prescription patterns over time were evaluated.

RESULTS: There were 2.6 million and 2.1 million ED visits for AOM during the first and last years of the study. Children ages 2-12 years accounted for about 40% of all ED visits for AOM, with another 40% in the younger than 2 years age group and 20% in the older than 12 years of age group. During the first and last year of the study, 79.2% and 91.3% of the patients with AOM were prescribed antibiotics, respectively. There was a slight increasing trend in the proportion prescribed antibiotics over time (p = 0.02). The rates of use of antibiotics for AOM were similar in all three age groups.

CONCLUSIONS: There was a slight increase in the percentage of children with AOM who were prescribed antibiotics in the ED between 1996 and 2005. There was also no change in the patterns of prescribing antibiotics.

PMID: 18045893 [PubMed - in process]