Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Infections in the Pediatric Population: Prevalence and management outcomes

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Abstract
Objectives: Infections by invasive methicillin-resistant Staphylococcus aureus (MRSA) are associated with higher morbidity and mortality compared to methicillin-susceptible Staphylococcus aureus (MSSA) infections, and have increased significantly in both healthy children and children with chronic illnesses. In our study we aimed to estimate the prevalence of invasive MSSA and MRSA among invasive Staphylococcus aureus (S. aureus) infections in the pediatric population and measure the association between management outcomes and methicillin resistance in these infections. Methods: We conducted an observational, analytical, retrospective cross-sectional, chart-review study of pediatric patients (aged ≤16 years) admitted to King Khalid University Hospital in Riyadh, Saudi Arabia during 2019–2023 with invasive S. aureus infections. Results: We identified 85 patients with invasive S. aureus infections who met our inclusion and exclusion criteria; 65.9% of all included cases had MSSA infections. Additionally, MRSA infections accounted for 62.5% of all deaths (odds ratio [OR] = 3.68; p = 0.075) suggesting a trend toward higher mortality among MRSA patients. Of those infected with S. aureus, 31.8% required admission to the intensive care unit (ICU), with similar admission rates for both MSSA and MRSA, and both groups had a median hospital stay of 25 days. Conclusion: We estimated the prevalence of MRSA infections to be 34.1%. Our study showed a trend toward higher mortality among individuals with invasive MRSA infections than among those with MSSA infections. However, the findings regarding ICU admission rates and length of hospital stay were inconclusive.

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