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Background: Emergence of methicillin-resistant Staphylococcus aureus (MRSA) infections among previously healthy persons in community settings (without exposure to healthcare facilities) has been noted recently. Limited studies have been carried out from India in an exclusive pediatric population on MRSA in community-acquired pyoderma. Aims: The objective of this study was to evaluate different types of primary pyoderma in children caused by S. aureus and to determine the incidence of MRSA in community-acquired primary pyoderma in children. Materials and Methods: Children aged ≤16 years with pyoderma caused by S. aureus who attended camps conducted in schools around Bengaluru were inducted. They were evaluated for a variety of skin infections which were cultured and analyzed for antimicrobial susceptibilities. Swabs from the anterior nares were also collected from each patient. Results: Of the total 372 children with pyoderma caused by S. aureus studied, 232 were boys and 140 were girls. Impetigo contagiosum (47%) was the most common form of pyoderma, followed by ecthyma (19.9%) and folliculitis (18.5%). The most common site involved was face in 48.4% patients, followed by legs in 32.5% patients. MRSA was isolated in 6.5% patients. Nasal colonization with S. aureus was observed in 59.7% patients. Conclusion: MRSA in community-acquired pyoderma in children was 6.5% and nasal colonization with S. aureus was 59.7% in our study. High resistance to commonly used antimicrobials in methicillin-sensitive S. aureus was also observed. Judicious use of antimicrobials is essential to control the emergence and spread of antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. It can also cause community-acquired infections. Indian reports about MRSA in community-acquired infections are rare. To evaluate the rate of MRSA in community-acquired pyoderma and the nasal colonisation with S. aureus in such patients. Two hundred and fifty patients with community-acquired pyoderma, who attended outreach camps around Mangalore, south India between January 2000 and July 2001, were studied. Swabs collected from the skin lesions and anterior nares were inoculated onto blood agar and MacConkey's agar. Antimicrobial sensitivity testing was performed using Kirby–Bauer disk diffusion, agar dilution, and agar screen. Of 250 pyoderma cases, S. aureus was isolated from 202 (80.8%) patients. Twenty-two (10.9%) S. aureus isolates were methicillin resistant, 179 (88.6%) were resistant to penicillin, and 114 (56.4%) were resistant to erythromycin. S. aureus colonization in the anterior nares was observed in 136 (54.4%) cases, 11.8% of which were MRSA. Antibiograms of clinical isolates of S. aureus matched with nasal isolates in 99 (49%) cases. The emergence of MRSA in the community is a warning. A high nasal carriage rate may contribute to recurrent pyoderma. A correct antimicrobial policy and the avoidance of inappropriate antimicrobial usage are mandatory to reduce the spread of MRSA in the community. [ABSTRACT FROM AUTHOR]