Infectious diseases and immunizationPediatric community-acquired methicillin-resistant Staphylococcus aureus infection and colonization: trends and managementPaintsil, ElijahAuthor Information Departments of Pharmacology and Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA Correspondence to Elijah Paintsil, Yale University School of Medicine, Departments of Pharmacology and Pediatrics, 333 Cedar Street, New Haven, CT 06520-8064, USA Tel: +1 203 785 4730; fax: +1 203 785 6961; e-mail: [email protected] Current Opinion in Pediatrics: February 2007 - Volume 19 - Issue 1 - p 75-82 doi: 10.1097/MOP.0b013e32801261c9 Buy Metrics Abstract Purpose of review The scourge of community-acquired methicillin-resistant Staphylococcus aureus in pediatrics continues unabated. This review provides information on changes in epidemiology, therapeutic considerations, and measures to control the epidemic. Recent findings The epidemiology and clinical manifestations of methicillin-resistant S. aureus have undergone important changes that pose challenges in recognition, diagnosis, and treatment for the pediatrician. Community-acquired methicillin-resistant S. aureus used to be predominantly associated with localized disease among previously healthy children; however, there are recent reports of more invasive and severe diseases with some fatalities. The antibiotic susceptibility pattern is also changing with some community-acquired methicillin-resistant S. aureus having resistance patterns indistinguishable from that of hospital-acquired methicillin-resistant S. aureus. Thus the choice of antibiotics is becoming even more challenging in pediatrics, with an already-limited armamentarium of antibiotics. The management of common skin diseases such as furunculosis and boils now requires close collaboration between the general pediatrician and the infectious diseases specialist. Summary As the burden of community-acquired methicillin-resistant S. aureus disease continues to increase, pediatricians must have a high index of suspicion and must institute appropriate antimicrobial therapy based on community or regional antibiotic susceptibility of community-acquired methicillin-resistant S. aureus. There is an urgent need for effective infection control programs, including active surveillance components, to help curb the epidemic. © 2007 Lippincott Williams & Wilkins, Inc.