1685. Epidemiological and microbiological characteristics of S. aureus pediatric infections in Colombia 2018-2022, a National Multicenter Study: Staphylored Colombia
Authors: Gutierrez-Tobar Ivan Felipe , Carvajal Cristobal , Vásquez Pablo , Camacho Jhon , Andrade-Fernandez Joam C , Londono-Ruiz Juan Pablo , Díaz Alejandro , Mariño Cristina , Luengas Miguel , Hernandez Derly , Toro Jessica F , Niño Angela , Patiño Jaime , Pérez Paola , Sandoval Lina , Vivas Rosalba , Calle Juan , Cabeza Nancy , Lopez Eduardo , Bustos Mario , Rodríguez Yazmin , Araque Paula , Beltran María , Galvis Diego , Lopez Juan , Camacho German , Jaimes Mayra , Beltran Claudia , Gonzalez Natalia , Reyes Jinnethe , Camacho Denisse , Chaucanes Yamile , Garces carlos , Arias Cesar A 
Published: November 2023

Abstract

Background
Staphylococcus aureus infections are a major cause of morbidity and mortality worldwide. Staphylored Colombia is a research network across various regions of Colombia. The present study aimed to describe the epidemiological and microbiological characteristics of S. aureus infections in pediatric patients from 2018 to 2021.

Methods
In this retrospective observational study, we analyzed S. aureus isolates from centers reported in WHONET, a WHO software for microbiology management. A S. aureus pediatric infection (“event”) was defined as any culture isolation in an individual who was previously culture negative for at least 2 weeks. We described center characteristics, age distribution, infection type, and antibiotic susceptibilities. Descriptive statistics were used to compare the microbiologic characteristics of meticillin-sensitive (MSSA) and resistant (MRSA) S. aureus isolates.
Various origins of S. aureus isolates, according to the approach in methodology: by culture, by event, and by patient

Results
We included 23 centers from 7 cities. Most of these centers (82.6%) provided care for both adults and children, 52.2% offering oncology services and 82.6% having a PICU (Table 1). A total of 8,157 S. aureus culture isolations were registered, from 5,384 events that occurred in 4,821 patients (Figure 1). Median age was 5 years (range 1-12). The most frequent infection source was blood (26.2%), followed by skin and soft tissue (18.4%). Most of S. aureus isolates remained susceptible to oxacillin (62.1%), clindamycin (85.9%), and TMP-SMX, 91.7%, with minor changes in the antimicrobial resistance overtime (Figure 2). MRSA prevalence varied by city (&lt; 0.001) and was slightly higher in exclusively pediatric hospitals (39.4% vs. 35.7%; p&lt; 0.001), and hospitals with neonatal units (p=0.004). Multiple foci were associated with an increased risk of MRSA (single origin 35.8% vs. three or more origins 56.4%; p&lt; 0.001), particularly in cases of bacteremia (Table 2).
The different characteristics of the centers are described, as well as the description of S. aureus according to the type of isolation: by culture, event, and patient
This table compares the SAMS vs SAMR isolates according to the characteristics of the centers and the general type of infection and its origin.
This graph describes how the resistance to different antibiotics for single events has been from 2018 to 2021

Conclusion
Our study, based on WHONET data, suggests that MRSA prevalence varies by region and hospital characteristics. Multifocal involvement and a higher number of infections were associated with an increased frequency of MRSA, particularly in cases of bacteremia. Prospective clinical studies are fundamental and currently ongoing to provide a more comprehensive characterization within the Staphylored LATAM network.

Disclosures
All Authors: No reported disclosures