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International Journal of Pediatrics
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International Journal of Pediatrics
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Aglua, I., Jaworski, J., Drekore, J., Urakoko, B., Poka, H., Michael, A., Greenhill, A. (2018). Methicillin-Resistant Staphylococcus Aureus in Melanesian Children with Haematogenous Osteomyelitis from the Central Highlands of Papua New Guinea. International Journal of Pediatrics, 6(10), 8361-8370. doi: 10.22038/ijp.2018.31279.2763
Izzard Aglua; Jan Jaworski; Jimmy Drekore; Bohu Urakoko; Harry Poka; Audrey Michael; Andrew Greenhill. "Methicillin-Resistant Staphylococcus Aureus in Melanesian Children with Haematogenous Osteomyelitis from the Central Highlands of Papua New Guinea". International Journal of Pediatrics, 6, 10, 2018, 8361-8370. doi: 10.22038/ijp.2018.31279.2763
Aglua, I., Jaworski, J., Drekore, J., Urakoko, B., Poka, H., Michael, A., Greenhill, A. (2018). 'Methicillin-Resistant Staphylococcus Aureus in Melanesian Children with Haematogenous Osteomyelitis from the Central Highlands of Papua New Guinea', International Journal of Pediatrics, 6(10), pp. 8361-8370. doi: 10.22038/ijp.2018.31279.2763
Aglua, I., Jaworski, J., Drekore, J., Urakoko, B., Poka, H., Michael, A., Greenhill, A. Methicillin-Resistant Staphylococcus Aureus in Melanesian Children with Haematogenous Osteomyelitis from the Central Highlands of Papua New Guinea. International Journal of Pediatrics, 2018; 6(10): 8361-8370. doi: 10.22038/ijp.2018.31279.2763

Methicillin-Resistant Staphylococcus Aureus in Melanesian Children with Haematogenous Osteomyelitis from the Central Highlands of Papua New Guinea

Article 7, Volume 6, Issue 10 - Serial Number 58, October 2018, Page 8361-8370  XML PDF (396 K)
DOI: 10.22038/ijp.2018.31279.2763
Authors
Izzard Aglua 1; Jan Jaworski2; Jimmy Drekore3; Bohu Urakoko2; Harry Poka4; Audrey Michael5; Andrew Greenhill6
1MBBS, MPH. Coordinator-Clinical Research Centre, Sir Jospeh Nombri Memorial-Kundiawa General Hospital, Papua New Guinea.
2MMed, Consultant Surgeons-Surgical Department, Sir Jospeh Nombri Memorial-Kundiawa General Hospital, Papua New Guinea.
3BSc. President-Simbu Children’s Foundation (SCF), Papua New Guinea.
4MMed, Consultant Pediatrician-Pediatric Department, Sir Jospeh Nombri Memorial-Kundiawa General Hospital, Papua New Guinea.
5BSc. Microbiologist-Papua New Guinea Institute of Medical Research (PNGIMR), Papua New Guinea.
6PhD. Microbiology Lecturer- Federation University, Australia.
Abstract
Background: Methicillin-Resistant Staphylococcus aureus (MRSA) has been an important cause of bone infection since the 1940s. Current guidelines recommend targeted antibiotic use for osteomyelitis treatment informed by microbial sensitivity patterns. However, in settings without microbiology facilities, empirical antibiotic use is common. Unrecognized antibiotic resistance potentiates persistence of MRSA with osteomyelitis progression to chronic forms with complications despite antibiotic treatment.
Materials and Methods: A prospective observational study was done to identify common etiological agent (s) in bone infection in Melanesian children (that were admitted to the two surgical and one pediatric wards of the SJNM-KUGH in the Simbu province of Papua New Guinea in 2012 and 2017), observe for presence of antimicrobial resistance, and determine effective antibiotic regimes for treatment of bone pediatric osteomyelitis. Seventy pediatric patients presenting from the community with osteomyelitis were recruited, with bone and non-bone specimens sampled, cultured and isolates tested for resistance to common antibiotics.
Results: Staphylococcus aureus (S. aureus) was isolated in 67% (47/70) of collected specimens. Of the 47 isolates, there was 91.5% resistance to penicillin, 85.1% resistance to methicillin, 89.4% resistance to oxacillin, 93.6% resistance to ampicillin and 80.9% resistance to ceftriaxone. S. aureus showed 91.5% sensitivity to gentamycin, 93.6% sensitivity to erythromycin, tetracycline and clindamycin, and 95.7% sensitivity to Co-trimoxazole.
Conclusion: MRSA was the leading cause of haematogenous osteomyelitis in Melanesian children. S.aureus was isolated mainly from infected long bones of the lower limbs (79%) of children presenting from the community, suggesting a predominantly community-associated MRSA.
Keywords
Children; MRSA; Osteomyelitis; Papua New Guinea
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