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Resumen Introduccion Staphylococcus aureus es una causa importante de infecciones neonatales de inicio en la comunidad. En los ultimos anos se ha notificado en Estados Unidos la emergencia de infecciones por cepas resistentes a la meticilina en este grupo de edad, aunque existen pocos estudios en Espana. El objetivo de este estudio es describir las caracteristicas epidemiologicas, clinicas y microbiologicas de las infecciones por S. aureus de inicio en la comunidad en neonatos. Metodos Estudio prospectivo de las infecciones neonatales por S. aureus de inicio en la comunidad realizado durante 3 anos (2007-2009) en el Servicio de Urgencias Pediatricas del Hospital 12 de Octubre de Madrid (Espana). Resultados Se registraron 30 casos de los que solo un aislado (3,3%) fue resistente a la meticilina y 2 (6,7%) fueron LPV(+). Conclusiones A pesar de la emergencia de SARM y/o productor de LPV fuera del ambiente hospitalario en poblacion pediatrica en Espana, dichas infecciones son todavia poco frecuentes en neonatos.

Panton-Valentine leukocidin (PVL) is a toxin associated with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) worldwide and also occurs in community-associated methicillin-susceptible S aureus (CA-MSSA) strains. The aims of the study were to determine the prevalence of PVL in community-onset S aureus skin and soft-tissue infections (SSTIs) and to analyse the influence of methicillin resistance and PVL presence on the clinical characteristics of these infections.We prospectively enrolled all children with S aureus community-onset SSTIs attending the emergency department of a tertiary hospital between 2007 and 2009. Results A total of 142 S aureus SSTIs were identified, 46 (32%) were PVL positive. The proportion of subjects in each group was: 89 (63%) PVL-MSSA, 33 (23%) PVL+MSSA, 13 (9%) PVL+MRSA and 7 (5%) PVL-MRSA. PVL+infections were more frequently abscesses (63% vs 39%, p0.01), and more often required incision and drainage (p0.01) and hospital admission (46% vs 26%, p=0.02). MRSA infections were also more frequently associated with abscesses but in a multivariable analysis only PVL remained independently related (OR 2.33; 95% CI 1.10 to 4.90).Our study found a high prevalence of PVL presence in community-onset S aureus SSTIs in children in Spain. This toxin is associated with more abscess formation, regardless of methicillin resistance.

Staphylococcus aureus is a major cause of neonatal community-onset infections. The emergence of methicillin-resistant S. aureus infections in this age group has been reported in USA in the last few years; however there are no studies in Spain. The aim of this study is to describe the epidemiological, clinical and microbiological characteristics of S. aureus community-onset infections in neonates.We prospectively reviewed the S. aureus infections in neonates over a three year period (2007-2009) in the Pediatric Emergency Department of Hospital 12 de Octubre in Madrid (Spain).We recorded 30 cases of neonatal S. aureus community-onset infections. Only one isolated (3.3%) was resistant to methicillin, and two (6.7%) were PVL(+).Despite the emergence of MRSA outside the hospital in pediatric population in Spain, CA-MRSA and SA PVL(+) infections are not frequent in neonates.