Antibiotic resistance pattern of Staphylococcus aureus infections in children


  • Senthil Kumar K. Department of Paediatrics, Karuna Medical College, Palakkad, Kerala, India
  • Ajith Brabhu Kumar C. WHO Surveillance Medical Officer, Deoria, Uttar Pradesh, India



Antibiotic resistance, MRSA, Staphylococcus aureus


Background: Methicillin resistant Staphylococcus aureus (MRSA) is endemic in India and is a dangerous pathogen for hospital acquired infections. Analysing antibiotic susceptibility pattern of Staphylococcus helps us to overcome the therapeutic difficulties created by the rising anti-microbial resistant bacteria and guide us in choosing appropriate antibiotics. Hence, this study was conducted.

Methods: Children with confirmed S. aureus infection between the age group of 0-12 years were classified into MSSA and MRSA subgroups. Isolates were identified as S. aureus using standard microbiological methodologies at diagnostic bacteriology laboratory, in the Microbiology department. Basic demographic variables and antibiotic resistance patterns were compared between MRSA and MSSA subgroups.

Results: Majority of S. aureus were isolated from pus followed by blood culture. Prevalence of community acquired MRSA in present study (80%, with 95% CI from 68.56% to 91.44%) was significantly higher when compared to another studies (p value=0.004). Resistance to gentamicin and ciprofloxacin among the MRSA isolates was more than that in methicillin sensitive S. aureus (MSSA) (P<0.001).

Conclusions: It is prudent to include MRSA coverage in empirical antibiotic regimens in settings where a significant proportion of patients hospitalized for S. aureus infection have MRSA.


Miller LG, Diep BA. Clinical practice: colonization, fomites, and virulence: rethinking the pathogenesis of community-associated methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;46:752-60.

Lowy FD. Staphylococcus aureus infections. N Engl J Med. 1998;339:520-32.

Cosgrove SE, Fowler VG Jr. Management of methicillin-resistant Staphylococcus aureus bacteremia. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;46Suppl 5:S386-93.

Deurenberg RH, Vink C, Kalenic S, Friedrich AW, Bruggeman CA, Stobberingh EE. The molecular evolution of methicillin-resistant Staphylococcus aureus.Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2007;13:222-35.

Boucher HW, Corey GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;46Suppl 5:S344-9.

Stryjewski ME, Chambers HF. Skin and soft-tissue infections caused by community-acquired methicillin-resistant Staphylococcus aureus. Clin Infect Dis Off Publ Infect Dis Soc Am. 2008;46Suppl 5:S368-77.

Chambers HF, Deleo FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol. 2009;7:629-41.

Hao H, Dai M, Wang Y, Huang L, Yuan Z. Key genetic elements and regulation systems in methicillin-resistant Staphylococcus aureus. Future Microbiol. 2012;7:1315-29.

Udo EE, Pearman JW, Grubb WB. Genetic analysis of community isolates of methicillin-resistant Staphylococcus aureus in Western Australia. J Hosp Infect. 1993;25:97-108.

Clinical and Laboratory Standards Institute. 2013. Performance standards for Antimicrobial susceptibility testing; twenty third Informational supplement. M100-S23.

Alvarez-Uria G, Reddy R. Prevalence and Antibiotic Susceptibility of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Rural Area of India: Is MRSA Replacing Methicillin-Susceptible Staphylococcus aureus in the Community? ISRN Dermatol. 2012;2012:248951.

Mallick SK, Basak S. MRSA--too many hurdles to overcome: a study from Central India. Trop Doct. 2010;40:108-10.

Ray P, Manchanda V, Bajaj J, Chitnis DS, Gautam V, Goswami P, et al. Methicillin resistant Staphylococcus aureus (MRSA) in India: prevalence and susceptibility pattern. Indian J Med Res. 2013;137(2):363-9.

Jung SI, Shin DH, Park KH, Shin JH. Antimicrobial susceptibility and clonal relatedness between community- and hospital-acquired methicillin-resistant Staphylococcus aureus from blood cultures. J Microbiol Seoul Korea. 2006;44:336-43.

Abdallah SA, Al-Asfoor KK, Salama MF, Al-Awadi BM. Prospective analysis methicillin-resistant Staphylococcus aureus and its risk factors. J Glob Infect Dis. 2013;5:19-25.

Chambers HF. Community-associated MRSA--resistance and virulence converge. N Engl J Med. 2005;352:1485-7.

Miller LG, Quan C, Shay A, Mostafaie K, Bharadwa K, Tan N, et al. A prospective investigation of outcomes after hospital discharge for endemic, community-acquired methicillin-resistant and -susceptible Staphylococcus aureus skin infection. Clin Infect Dis Off Publ Infect Dis Soc Am. 2007;44:483-92.






Original Research Articles