Staphylococcal Infections in Children, California, USA, 1985–2009

Kathleen Gutierrez

, Meira S. Halpern, Clea Sarnquist, Shila Soni¹, Anna Chen Arroyo, and Yvonne Maldonado

Author affiliations: Author affiliations: Stanford University School of Medicine, Stanford, California, USA

Abstract

We conducted a retrospective, observational, population-based study to investigate the effect of staphylococcal infections on the hospitalization of children in California during 1985–2009. Hospitalized children with staphylococcal infections were identified through the California Office of Statewide Health Planning and Development discharge database. Infections were categorized as community onset, community onset health care–associated, or hospital onset. Infection incidence was calculated relative to all children and to those hospitalized in acute-care facilities. A total of 140,265 records were analyzed. Overall incidence increased from 49/100,000 population in 1985 to a peak of 83/100,000 in 2006 and dropped to 73/100,000 in 2009. Staphylococcal infections were associated with longer hospital stays and higher risk for death relative to all-cause hospitalizations of children. The number of methicillin-resistant Staphylococcus aureus infections increased, and the number of methicillin-susceptible S. aureus infections remained unchanged. Children <3 age="age" and="and" at="at" blacks="blacks" for="for" higher="higher" hospitalization.="hospitalization." insurance="insurance" of="of" p="p" private="private" risk="risk" those="those" were="were" without="without" years="years">

The increasing prevalence of antimicrobial drug–resistant staphylococcal infections is a threat to public health in the United States. Methicillin-resistant Staphylococcus aureus (MRSA) is now a frequent cause of skin, soft tissue, and invasive S. aureus infections requiring hospitalization in the United States (1–6).
The characteristics of staphylococcal infection in children in particular communities have been described (7–9). However, there are fewer population-based studies, and little is known about changes in MRSA transmission among children in California. We conducted a retrospective observational study to determine the incidence of and trends in staphylococcal infection–associated hospitalizations among children in California during 1985–2009.

Staphylococcal Infections in Children, California, USA, 1985–2009

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This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the ACCME to provide continuing medical education for physicians.
Medscape, LLC designates this Journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 70% minimum passing score and complete the evaluation at www.medscape.org/journal/eid; (4) view/print certificate.

Release date: December 12, 2012; Expiration date: December 12, 2013

Learning Objectives

Upon completion of this activity, participants will be able to:
• Assess temporal trends of staphylococcal infection among hospitalized children
• Distinguish risk factors for staphylococcal infection among hospitalized children
• Analyze clinical characteristics of staphylococcal infection among hospitalized children
• Evaluate the microbiology of staphylococcal infection among hospitalized children.

CME Editor

Claudia Chesley, Technical Writer/Editor, Emerging Infectious Diseases. Disclosure: Claudia Chesley has disclosed no relevant financial relationships.

CME Author

Charles P. Vega, MD, Health Sciences Clinical Professor; Residency Director, Department of Family Medicine, University of California, Irvine. Disclosure: Charles P. Vega, MD, has disclosed no relevant financial relationships.

Authors

Disclosures: Kathleen Gutierrez, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Cerexa. Meira S. Halpern, PhD; Clea Sarnquist, DrPH, MPH; Shila Soni, MS; and Anna Chen Arroyo, MD, PhD, have disclosed no relevant financial relationships. Yvonne Maldonado, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for DMC, Pfizer; received grants for clinical research from National Institutes of Health, Centers for Disease Control and Prevention, World Health Organization, State of California.