Citation Information :
Bhattacharya D, Suthar R, Saini A, Malik MA, Munda VS, Gautam V. Disseminated Staphylococcal Disease in Neonates Admitted to Pediatric Emergency of a Developing Economy: Clinicomicrobiological Profile, Management, and Outcome. J Postgrad Med Edu Res 2020; 54 (2):45-49.
Aim: To report clinical and microbiological profile, complications, management, and short-term outcome of neonates with disseminated staphylococcal disease. Materials and methods: This retrospective study was conducted in pediatric emergency of a tertiary-care teaching hospital in North India involving 26 outborn neonates admitted with diagnosis of disseminated staphylococcal disease over 1-year period (January–December 2018). Results: Majority of the neonates presented between day 7 and day 28 of life with mean duration of illness of 6.6 (2.4) days. The risk factor for disseminated staphylococcal disease was noted in 38.5% (n = 10) cases (intramuscular injection, venous cannula, nonpenetrative trauma, and umbilical line). Skin and subcutaneous tissue abscesses were the commonest localization (88.5%) followed by pneumonia (30.8%), meningitis (26.9%), septic arthritis (19.2%), and osteomyelitis (11.5%). Staphylococcus aureus was isolated in 53.8% cases, and methicillin-resistant Staphylococcus aureus (MRSA) accounted for 71.4% of isolates. Common complications were acute kidney injury, respiratory failure, and shock (in 26.9% each) and venous thrombosis and septic ileus (in 7.7% each). The duration of appropriate antibiotics was 16.5 (6.4) days. Incision and drainage of abscesses was done in 53.8% cases, 19.2% underwent arthrotomy, 27% needed vasoactive drugs, and 19% received invasive mechanical ventilation. The duration of hospital stay was 17.7 (8.7) days, and mortality was 15.4% (n = 4). Conclusion: Disseminated staphylococcal disease is common in neonates. The skin and soft tissue focus with hematological spread to distant organs lead to fulminant disseminated disease. High index of suspicion, early diagnosis, prompt appropriate antibiotics, and early surgical debridement are integral part of management. The MRSA contributes to significant burden.
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