Bacteriemias por Staphylococcus aureus adquiridas en la comunidad: 17 a？os de experiencia en ni？os de la Argentina

background. community-acquired methicillin-resistant staphylococcus aureus (camrsa) emerged in recent years. few studies analyzed the impact of these infections in bacteremias (b). objectives. to analyze clinical, epidemiological, microbiological and outcome of casa b between two periods (period i: 1993-2004, and period ii: 2004-2007). material and methods. retrospective, observational and comparative study. all children older than 1 month of age and casab were included. results. during the study period 647 sab were diagnosed (period i: 499 and period ii: 148). of them, 140 (28%) and 49 (33%) were csab, respectively. the median age of patients was 5.9 and 4.8 years, respectively (p= ns). clinical foci of infection and septic shock were more frequent in the period i (78% vs. 47%) and (5% vs. 16%) (p <0.05), respectively. skin infection and septic shock were similar in both periods (78% vs. 67% and 5% vs. 8%; p= ns). four camrsa b (3%) were diagnosed during the first period. one predisposing factor was identified in all cases. inversely, 23 cases (47%) were diagnosed during the period ii (p <0.05). resistance rates to clindamycin and gentamicin were more high during the second period (10% vs. 2% and 20% vs. 3%, respectively) (p <0.05). patients in the second period had longer antibiotic treatment (x 16.6 vs. 10.1 days) and more frequent inappropriate treatment at admission (53% vs. 5%) (p <0.05). hospital stay time was longer during de first period (19.2 vs. 12.2 days) (p <0.05). the mortality rate was higher in the first period (13% vs. 4%) (p= ns). conclusion. a significant increase of camrsa b were detected in recent years. it is necessary to evaluate the empirical treatment of severe community infections in children in our country.