XVII Annual Conference of IAP Maharashtra State (Mahapedicon 2006, Solapur, 3-5th November 2006)

Vinayak Patki, Amit Tagare, Jennifer Auntin, Aniket Potdar

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Aims & objective: To study clinical manifestations, complication, sensitivity pattern and outcome on severe staphylococcal infection in children.

Material & Methods: 8 Cases of culture proven Staphylococcal aureus infection admitted in PICU in last 6 months were studied retrospectively & analysed.

Results: Cases were from age group 6 month to 16 years median age 7years. 6 (75%) were male. All were referred from other pediatric hospital with median stay of 4 days hospital stay. No patient was suffering form any congenital or acquired immunodeficiency, 6 had extensive pneumonia out of which two had ARDS, 5 cases had empyema thoracis, one had pyopericardium, 2 had staphylococcal scalded skin syndrome. 3 patients had septic arthritis, 1 had multiple visceral abscess. 6 required mechanical ventilation and 4 had DIC. Bacterial culture grew staphylococcus aureus within 48 hours of incubation in 7 cases and within 1 week in one case. All cases were resistant to routine penicillin derivative, macrolides, amikacin, and quinolones. 6 were resistant to vancomycin also and were sensitive to only timentin and meropenem. No child was succumbed but have prolonged hospital stay (mean duration of 16 days). Two case required decortication surgery.

Conclusion: Staphylococcal infections contribute to major morbidity in PICU. Vancomycin resistant strains are increasing. Intensive supportive management gives good outcome despite long hospital stay and high cost of treatment.