{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:07:34Z","timestamp":1775840854342,"version":"3.50.1"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:00:00Z","timestamp":1633651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Extracorporeal membrane oxygenation (ECMO) is increasingly utilized for pediatric sepsis unresponsive to steroids and inotropic support. Outcomes of children with sepsis are influenced by the type of pathogen causing their illness.<\/jats:p><jats:p><jats:bold>Objective:<\/jats:bold> To determine if the outcomes of children with <jats:italic>Staphylococcus aureus<\/jats:italic> sepsis receiving ECMO differed according to microbial sensitivity (Methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> [MRSA] vs. Methicillin-sensitive <jats:italic>Staphylococcus aureus<\/jats:italic> [MSSA]).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Retrospective case-matched cohort study of children (0\u2013&amp;lt;18 years) with <jats:italic>Staphylococcus aureus<\/jats:italic> sepsis reported to the ELSO registry from more than 995 centers. Inclusion criteria were age 0\u201318 years, laboratory diagnosis of Staphylococcal infection, clinical diagnosis of sepsis, and ECMO deployment. Exclusion criteria were no laboratory diagnosis of Staphylococcal infection. We compared patient demographics, pre-ECMO management and outcomes of those with MRSA vs. MSSA using Chi-Square test, with independent samples <jats:italic>t<\/jats:italic>-test used to test to compare continuous variables.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> In our study cohort of 308 patients, 160 (52%) had MSSA and 148 (48%) MRSA with an overall survival rate of 41.5%. There were no differences in the age group (<jats:italic>p<\/jats:italic> = 0.76), gender distribution (<jats:italic>p<\/jats:italic> = 0.1) or racial distribution (<jats:italic>p<\/jats:italic> = 0.58) between the two groups. <jats:italic>P<\/jats:italic> value for racial distribution should be 0.058. There were 91 (56.8%) deaths in the MSSA group and 89 (60.1%) deaths (<jats:italic>p<\/jats:italic> = 0.56) in the MRSA group. Duration on ECMO (<jats:italic>p<\/jats:italic> = 0.085) and the time from intubation to ECMO (<jats:italic>p<\/jats:italic> = 0.37) were also similar in the two groups. Survival with MSSA sepsis and MRSA sepsis did not improve significantly over the 20 years evaluated despite an increase in ECMO utilization.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> In this multi-center retrospective study, there were no differences in outcomes for children receiving ECMO support with <jats:italic>Staphylococcus aureus<\/jats:italic> sepsis according to microbial methicillin sensitivity. There was no significant increase in survival among patients with MRSA and MSSA infections receiving ECMO in the last 20 years.<\/jats:p>","DOI":"10.3389\/fped.2021.706638","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T18:37:57Z","timestamp":1633891077000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Outcomes of Pediatric Patients With Sepsis Related to Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus Infections Requiring Extracorporeal Life Support: An ELSO Database Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Cortney","family":"Foster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayanand","family":"Bagdure","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Custer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Holloway","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Rycus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenni","family":"Day","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Bhutta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1097\/MOP.0000000000000337","article-title":"Pediatric sepsis","volume":"28","author":"Mathias","year":"2016","journal-title":"Curr Opin Pediatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1097\/PCC.0000000000001502","article-title":"Hospital variation in risk-adjusted pediatric sepsis mortality","volume":"19","author":"Ames","year":"2018","journal-title":"Pediatr Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1097\/PCC.0000000000000254","article-title":"Pediatric severe sepsis: current trends and outcomes from the Pediatric Health Information Systems database","volume":"15","author":"Ruth","year":"2014","journal-title":"Pediatr Crit Care Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e52","DOI":"10.1097\/PCC.0000000000002198","article-title":"Surviving Sepsis Campaign International guidelines for the management of septic shock and sepsis-associated organ dysfunction in children","volume":"21","author":"Weiss","year":"2020","journal-title":"Pediatr Crit Care Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/s41579-018-0147-4","article-title":"Methicillin-resistant Staphylococcus aureus: an overview of basic and clinical research","volume":"17","author":"Turner","year":"2019","journal-title":"Nat Rev Microbiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3947\/ic.2013.45.2.202","article-title":"Impact of methicillin-resistance on mortality in children and neonates with Staphylococcus aureus bacteremia: a meta-analysis","volume":"45","author":"Park","year":"2013","journal-title":"Infect Chemother."},{"key":"B7","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1186\/s13054-015-1105-4","article-title":"Extracorporeal therapies in pediatric severe sepsis: findings from the pediatric health-care information system","volume":"19","author":"Ruth","year":"2015","journal-title":"Crit Care"},{"key":"B8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.jpedsurg.2011.10.018","article-title":"Improved survival in venovenous versus venoarterial extracorporeal membrane oxygenation for pediatric noncardiac sepsis patients: a study of the Extracorporeal Life Support Organization registry","volume":"47","author":"Skinner","year":"2012","journal-title":"J Pediatr Surg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1016\/S0003-4975(96)01272-6","article-title":"Results of extracorporeal membrane oxygenation in children with sepsis. 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