Current trends in community-acquired methicillin-resistant Staphylococcus aureus at a tertiary care pediatric facility

Background. The prevalence of community-acquired methicillin-resistant Stap hylococcus aureus (MRSA) infections increased at the University of Chicago Children's Hospital (UCCH) from 10 per 100 000 admissions from 1988 to 1990 to 259 per 100 000 admissions from 1993 to 1995. Because this increase may have represented a one time occurrence or a limited disease outbreak, we u pdated our previous observations at UCCH in 1998 and 1999 to see whether th is trend had continued. Design. Prospective observational study. Results. Twenty-three hospitalized children had an MRSA isolate during the 1-year study period. Ten were community-acquired, equally distributed betwe en children with predisposing risk factors and those without. The overall p revalence of community-acquired MRSA was 208 per 100 000 admissions. Seven of the 10 community-acquired MRSA isolates were susceptible to clindamycin. Skin and soft tissue infections predominated among the children with a com munity-acquired MRSA isolate. Pulsed field gel electrophoresis of the 10 co mmunity-acquired MRSA isolates revealed 8 distinct patterns; these data sug gest that multiple clones were circulating at UCCH Conclusion. MRSA are no longer confined to children with established risk f actors. The prevalence of community-acquired MRSA among children without id entified risk factors is high in our institution.