Table 4.
Selected characteristics of children with Staphylococcus aureus nonbloodstream infection and vancomycin MICs of 2 μg/ml, Alfred I. DuPont Hospital for Children, 1 April 2000 to 31 March 2008
| Characteristic | MSSA (n = 10) | MRSA (n = 4) | P value |
|---|---|---|---|
| Age, median (range) (yr) | 8 (0–16) | 15 (3–19) | 0.12 |
| Male sex (n [%]) | 5 (50) | 2 (50) | |
| Underlying condition (n) | |||
| Osteomyelitis | 3 | 1 | |
| Malignancya | 2 | ||
| Hydrocephalus | 1 | ||
| Congenital heart diseaseb | 1 | ||
| Spine malformationc | 2 | 2 | |
| Previous vancomycin exposure (n [%])d | 2 (20) | 1 (25) | |
| Sepsis (n) | 1 | 1 | |
| Central venous access (n) | 7 | 2 | 0.5 |
| Site of infection (n) | |||
| Skin and soft tissue | 1 | 1 | |
| Surgical site infection | 5 | 2 | |
| Bone | 3 | 1 | |
| Lung | 1 | ||
| Empirical antibiotic therapye (n) | |||
| Vancomycin | 1 | ||
| Vancomycin + β-Lactamf | 3 | 1 | |
| Vancomycin + clindamycin | 1 | 1 | |
| Vancomycin + rifampin | 1 | 1 | |
| β-Lactam | 5 | ||
| Definitive antibiotic therapyg (n) | |||
| Vancomycin alone | 1 | 2 | |
| Vancomycin + rifampin | 1 | ||
| β-Lactam | 10 | ||
| Linezolid | 1 | 1 | |
| Duration of therapy (mean [range]) (days) | 33 (7–42) | 36 (30–42) | 0.45 |
| Mortalityh (n) | 0 | 0 |
Leukemia, brain tumor.
Congenital heart disease, tetralogy of Fallot.
Spine malformations, neuromuscular and idiopathic scoliosis, spina bifida.
Patients with previous vancomycin exposure, measured as doses of vancomycin administered, 6 months prior to the documented S. aureus infection.
Antibiotic agents given pending culture reports.
β-Lactam antibiotics included oxacillin, nafcillin, cefazolin, cefepime, cefotaxime, ceftriaxone, and piperacillin-tazobactam.
Antibiotic therapy given based on identification and susceptibility report.
All-cause and attributable mortality.