최근 포도알균화상피부증후군 환아에서 Methicillin-resistant Staphylococcus aureus 감염 경향과 항생제 사용에 관한 연구: 단일 기관 경험

Abstract

Background: Staphylococcal scalded skin syndrome (SSSS) is a blistering disease of superficial skin mediated by Staphylococcus aureus (S. aureus) exfoliative toxin. Generally, SSSS affects mainly infants and children younger than 5 years and has a good prognosis. However, an increasing number of cases of methicillin-resistant S. aureus (MRSA) have been reported recently. Objective: The purposes of this study were to evaluate the clinical features and course, to investigate the microbiological manifestations, and to perform antimicrobial susceptibility testing of SSSS among Korean children. Methods: From March 2003 to July 2016, a total of 141 children were included in this study. The patients were divided into two different groups according to time of onset of their disease: before or after September 2011. We retrospectively reviewed medical records, microbiological results, bacterial detection sites, and antimicrobial susceptibility tests of all participating children. The results of comparison between the two groups were evaluated using the chi-square test. Results: S. aureus infections were identified in all patients. Among all cultured S. aureus specimens, 63.1% (89/141) showed methicillin resistance. Beginning in September 2011, MRSA infection showed a significantly higher prevalence than that previously demonstrated (71.7% vs. 38.8%; p=0.0010). Moreover, MRSA infections were detected on the skin and neck and in the nose (each detected on 61, 41, and 18 occasions, respectively) with overlap observed in many cases. Conclusion: In conclusion, since the prevalence of MRSA infection has been gradually increasing in recent years, careful consideration is needed in the selection of antibiotics covering MRSA.