Background: Several studies have reported increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection among patients with no predisposing factors. This paper aims to determine the clinical and epidemiologic profile of community-associated MRSA (CA-MRSA) infection among children admitted at UP-PGH. Methodology: A retrospective review of the medical records of patients 0-to-18 years old with S. aureus isolate admitted at University of the Philippines-Philippine General Hospital (UP PGH) from January 1, 2007 to December 31, 2008 was conducted. S. aureus isolates were classified as methicillin-susceptible S. aureus (MSSA), CA-MRSA or healthcare-associated MRSA (HA-MRSA). Risk factors for MRSA acquisition were identified. Demographic data, site of infection, outcome, and antibiotic susceptibility patterns were compared. Results: S. aureus was isolated in 382 children. Medical records of 219 (57.33%) patients were available for review. Of the 219 patients, 40.64% had MSSA, 15.07% had CA-MRSA, and 44.3% had HA-MRSA isolates. The prevalence of CA-MRSA is seven per 1000 admissions. There was no statistical difference between the age, sex, outcome and the site of infection among the three groups. The most common source of isolates was exudates, followed by blood. There were statistically significant differences in the resistance patterns of S. aureus isolates, with MSSA and CA-MRSA having lower resistance rates (<10%) as compared to HAMRSA (>40%) and non-beta lactam antibiotics such as tetracycline, clindamycin, cotrimoxazole, gentamicin and vancomycin. Conclusion: This study showed that MRSA infection is no longer limited to patients with predisposing factors. The type of S. aureus infection cannot be predicted based on clinical and demographic profile of patients. Based on the susceptibility patterns in this study, CA-MRSA may be treated with tetracycline, clindamycin, cotrimoxazole, gentamicin and vancomycin.
Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; STAPHYLOCOCCUS AUREUS ; TETRACYCLINE ; CLINDAMYCIN ; TRIMETHOPRIM-SULFAMETHOXAZOLE COMBINATION ; GENTAMICINS ; VANCOMYCIN

Background and Objectives: Immature platelet fraction (IPF) is a new hematologic parameter that reflects the rate of thrombopoiesis. It has been suggested to be a predictor of platelet recovery in patients with thrombocytopenia. This study aimed to determine the relationship between IPF and platelet count among pediatric patients with thrombocytopenia due to dengue fever. Methods: This was a prospective cross-sectional study of 77 thrombocytopenic pediatric dengue fever patients. IPF was included in the daily complete blood count extraction. Baseline and daily IPF, platelet count, hematocrit, white blood cell count and presence of fever were recorded according to day of illness. The pattern of IPF in relation to the pattern of platelet count was analyzed. The proportion of patients showing platelet recovery at different time points was also determined. A receiver operating characteristic analysis was done to determine an IPF cut-off value predictive of platelet recovery within 24 hours. Results: The IPF increased as the platelet count decreased. The highest increase in IPF coincided with the trough of platelet count. Eighty -seven percent of the patients showed platelet recovery after the increasing trend of IPF, 87% after the peak value and 95% after the decreasing trend. An IPF value of more than 6.6% was found to be predictive of platelet recovery within 24 hours, with a sensitivity of 45% and specificity of 70%. Conclusion There was an observed inverse relationship between IPF and platelet count but with a statistically weak correlation. The decreasing trend of IPF can be a possible good predictor of an increasing trend in platelet count. These findings suggest a possible role of IPF as an additional parameter to predict platelet recovery in pediatric dengue fever patients.
Thrombocytopenia ; Dengue