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Community‐acquired Staphylococcus aureus pneumonia among hospitalized children in Hawaii
Author(s) -
Len Kyra A.,
Bergert Lora,
Patel Shilpa,
Melish Marian,
Kimata Chieko,
Erdem Guliz
Publication year - 2010
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.21269
Subject(s) - medicine , pneumonia , pacific islanders , methicillin resistant staphylococcus aureus , staphylococcus aureus , retrospective cohort study , intubation , community acquired pneumonia , tachypnea , pediatrics , surgery , population , environmental health , biology , bacteria , genetics , tachycardia
Background Invasive community acquired (CA) Staphylococcus aureus (SA) disease has been endemically observed in Hawaiian children. We wanted to evaluate the clinical, laboratory findings, and outcomes of methicillin‐resistant SA (MRSA) and methicillin‐susceptible SA (MSSA) associated pneumonia admissions. Methods We performed retrospective chart reviews of 38 culture proven SA pneumonia patients admitted to a pediatric tertiary medical center in Hawaii between January 1996 to December 2007. Results Twenty‐six patients (68%) had MRSA and 12 patients (32%) had MSSA infection. The mean age of MRSA patients was 2.8 and 6.7 years for MSSA patients ( P < 0.05). Pacific Islander and Native Hawaiian patients were affected disproportionately compared to non‐Pacific Islander and Hawaiian groups ( P < 0.0001). Demographic data, days of fever, tachypnea, hypoxia, and length of stay (LOS) were not significantly different between MRSA and MSSA infected patients. The mean LOS was 26.2 days (range 6–138 days); mean length of fever was 12.4 days. Seventy five percent (15 of 20) of patients who required intubation had MRSA. Twenty‐one of the 29 (72%) total patients with pleural effusions had MRSA infection and all required chest tube placements. Two (5%) patients died; both had MRSA infection. Conclusions Younger Pacific Islander/Native Hawaiian children were affected disproportionately and had MRSA infection more frequently. MRSA infected patients appeared to have severe disease with frequent chest tube placement, intubation, and fatality. Overall, both MRSA and MSSA pneumonia resulted in prolonged hospitalization, multiple complications, and significant healthcare costs. Pediatr. Pulmonol. 2010; 45:898–905. © 2010 Wiley‐Liss, Inc.