Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) commonly causes skin and soft tissue infections but can also involve other organs. CA-MRSA is resistant to all β-lactam agents. Common treatments include clindamycin, trimethoprim-sulfamethoxazole, and tetracycline. This study aimed to identify the prevalence and antimicrobial susceptibility profile of CA-MRSA isolated from pediatric patients between 2018 and 2022. Cross-sectional observational study using electronic medical records and the Hospital Infection Control Service database. S. aureus isolates and antimicrobial susceptibility profiles were analyzed. Ethics committee approval was obtained. Of 612 staphylococcal infections identified between 2018 and 2022, 40.7% were caused by CA-MRSA, distributed as follows: 2018 (0%); 2019 (80.0%); 2020 (38.8%); 2021 (41.8%); 2022 (42.5%). Skin and soft tissue infections were the most common presentation. The median length of hospital stay for patients with CA-MRSA infection was 8 days, twice that of those infected with methicillin-sensitive S. aureus (CA-MSSA), whose median stay was 4 days. Resistance to clindamycin was 35.9%, trimethoprim-sulfamethoxazole 17.0%, and tetracycline 11.3%. No vancomycin resistance was observed. A high prevalence of CA-MRSA infections was observed, along with worse clinical outcomes compared with CA-MSSA. The high rate of Clindamycin resistance in CA-MRSA is concerning, as it reduces the available antimicrobial options for treating infections caused by this pathogen. CA-MRSA infections are more likely to lead to bacteremia, longer hospital stays, prolonged antibiotic therapy, greater need for intensive care, and an increased risk of death compared with CA-MSSA infections.
Lemos et al. (2026) studied this question.