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Current Pediatric Research| Volume: 22
November 28-29, 2018 | Dubai, UAE
15
th
World Congress on
Pediatrics, Clinical Pediatrics and Nutrition
28
th
International Conference on
Nursing Practice
Joint Event
&
Methicillin-ResistantStaphylococcusaureus
inmelanesianchildrenwithHaematogenousOsteomyelitis
from the Central Highlands of Papua New Guinea
Izzard Aglua
1
, Jan Jaworski
1
, Jimmy Drekore
2
, Bohu Urakoko
2
, Harry Poka
1
, Audrey Michael
3
and
Andrew Greenhill
4
1
Sir Jospeh Nombri Memorial-Kundiawa General Hospital, Papua New Guinea
2
Simbu Children’s Foundation (SCF), Papua New Guinea
3
Papua New Guinea Institute of Medical Research (PNGIMR), Papua New Guinea
4
Federation University, Australia
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.
Method:
A prospective observational study done to identify
common etiological agent (s) in bone infection in Melanesian
children, observe for presence of antimicrobial resistance, and
determine effective antibiotic regimes for treatment of bone
paediatric osteomyelitis. 70 paediatric 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.
Result:
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. S.aureus also
showed 80.9% resistance to ceftriaxone, indicating a potential
multidrug resistant MRSA strain. There was > 91% sensitivity to
chloramphenicol, tetracyclin, co-trimoxazole, gentamycin and
erythromycinwhich could be used to effectively treat paediatric
osteomyelitis in the region.
Speaker Biography
Izzard Aglua holds an MBBS and MPH from James Cook University (Australia). He currently
coordinates clinical research on osteomyelitis, stroke andMDR TB at the Kundiawa General
Hospital Clinical Research Center in the Simbu Province of Papua New Guinea. He also
serves as General Internal Medicine Registrar and Dive Medical Officer for the region. His
researchwork includes identifying genotypes of MRSA isolates frompediatric osteomyelitis
and MDR TB isolates from the hospital and assessing speed of recovery between right
and left weaknesses after stroke. He has recently published work on both stroke and
osteomyelitis as a young researcher and has recently joined the editorial board of the AS
Pediatrics and Current Pediatric Reviews.
e:
izzard.agua@gmail.comIzzard Aglua et al., Pediatrics and Clinical Pediatrics 2018
& Nursing Practice 2018, Volume 22
DOI: 10.4066/0971-9032-C2-005