Staphylococcus aureus infections in pediatric patients with diabetes mellitus

Summary Objectives To describe Staphylococcus aureus infections in children with diabetes mellitus (DM). Methods Children with DM (cases) and S. aureus infections (2/02-6/10) were identified from a surveillance database. Patient charts were reviewed, and S. aureus isolates were characterized by mole...

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Published in:	The Journal of infection Vol. 65; no. 2; pp. 135 - 141
Main Authors:	Menne, Erin N, Sonabend, Rona Yoffe, Mason, Edward O, Lamberth, Linda B, Hammerman, Wendy A, Minard, Charles G, Kaplan, Sheldon L, Hulten, Kristina G
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Ltd 01-08-2012 Elsevier
Subjects:	Adolescent Bacterial diseases Biological and medical sciences Child Child, Preschool Diabetes Diabetes Complications - epidemiology Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female General aspects Glycemic Index Human bacterial diseases Humans Infection Infectious Disease Infectious diseases Male Medical sciences MRSA Risk Factors Staphylococcal Infections - epidemiology Staphylococcal infections, streptococcal infections, pneumococcal infections Staphylococcus aureus Staphylococcus aureus - isolation & purification Infection Glycemic index Diabetes Staphylococcus aureus MRSA Endocrinopathy Human Diabetes mellitus Bacteriosis Bacteria Micrococcales Micrococcaceae Staphylococcal infection Child
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Summary:	Summary Objectives To describe Staphylococcus aureus infections in children with diabetes mellitus (DM). Methods Children with DM (cases) and S. aureus infections (2/02-6/10) were identified from a surveillance database. Patient charts were reviewed, and S. aureus isolates were characterized by molecular methods. Cases were compared to age-matched controls without DM but with CA- S. aureus skin and soft tissue infections (SSTI) using conditional logistic regression. Results Forty-seven cases were identified; 41 were matched with 123 controls. Four cases had osteomyelitis and 43 had SSTI. Mean age was 14.2 years and 63% of cases had hemoglobin (Hb) A1c levels above 10%. Cases and controls differed by gender (85% vs. 45% female, P < 0.001), BMI% (median 87% vs. 72%, P = 0.04), methicillin-resistant S. aureus (MRSA) infection (49% vs. 68%, P = 0.04), and recurrent infections (22% vs. 4%, P = 0.001). Among cases, 88% of recurrences were caused by MRSA. Conclusions The majority of cases had poor glycemic control, more recurrences, fewer primary MRSA infections and were more likely to be female compared to a control group. Improved glycemic control may reduce the risk for infection, and decrease hospitalizations due to S. aureus infections.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0163-4453 1532-2742
DOI:	10.1016/j.jinf.2012.04.001