Community-acquired MRSA becoming more common in pediatric ICU patients

March 25, 2010

Once considered a hospital anomaly, community-acquired infections with drug-resistant strains of the bacterium Staphylococcus aureus now turn up regularly among children hospitalized in the intensive-care unit, according to research from the Johns Hopkins Children's Center.

The Johns Hopkins Children's team's findings, to be published in the April issue of the journal Emerging Infectious Diseases, underscore the benefit of screening all patients upon hospital admission and weekly screening thereafter regardless of symptoms because MRSA can be spread easily to other patients on the unit.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is a virulent subset of the bacterium and impervious to the most commonly used antibiotics. Most CA-MRSA causes skin and soft-tissue infections, but in ill people or in those with weakened immune systems, it can lead to invasive, sometimes fatal, infections.

In 2007, The Johns Hopkins Hospital began screening all patients upon admission and weekly thereafter until discharge. Some states have made patient screening mandatory but the protocols vary widely from hospital to hospital and from state to state.

"MRSA has become so widespread in the community, that it's become nearly impossible to predict which patients harbor MRSA on their body," says lead investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Hopkins Children's.

"Point-of-admission screening in combination with other preventive steps, like isolating the patient and using contact precaution, can help curb the spread of dangerous bacterial infections to other vulnerable patients."

The new Johns Hopkins study found that 6 percent of the 1,674 children admitted to the pediatric intensive-care unit (PICU) at Hopkins Children's between 2007 and 2008 were colonized with MRSA, meaning they carried MRSA but did not have an active infection. Of the 72 children who tested positive for MRSA, 60 percent harbored the community-acquired strain and 75 percent of all MRSA carriers had no previous history or MRSA. MRSA was more common in younger children, 3 years old on average, and among African-American children. The reasons behind the age and racial disparities in MRSA colonization remain unclear, the investigators say. Patients with MRSA had longer hospital stays (eight days) than MRSA-free patients (five days) and longer PICU stays (three days) than non-colonized patients (two days).

Eight patients who were MRSA-free upon admission became colonized with MRSA while in the PICU. Of the eight, four developed clinical signs of infection, meaning that the other four would have never been identified as MRSA carriers if the hospital was not performing weekly screenings of all patients.
-end-
The research was funded in part by the National Institutes of Health, the Thomas Wilson Sanitarium for Children in Baltimore and by the Centers for Disease Control and Prevention.

Other investigators in the study included Karen Carroll, M.D.; Tracy Ross; Alexander Shangraw; and Trish Perl, M.D., M.S.; all of Hopkins.

Related on the Web:

In the Fight Against Life-Threatening Catheter Infections, Length of Use is Key
http://www.hopkinschildrens.org/In-the-Fight-Against-Life-Threatening-Catheter-Infections-Length-of-Use-of-Key.aspx

MRSA
http://www.hopkinsmedicine.org/heic/ID/mrsa/

Simple Steps Prevent Life-Threatening Bloodstream Infections in Children
http://www.hopkinschildrens.org/Simple-Steps-Prevent-Life-Threatening-Bloodstream-Infections-in-Children.aspx

Johns Hopkins Children's Center
http://www.hopkinschildrens.org

Johns Hopkins Medicine

Related MRSA Articles from Brightsurf:

Widely available antibiotics could be used in the treatment of 'superbug' MRSA
Some MRSA infections could be tackled using widely-available antibiotics, suggests new research from an international collaboration led by scientists at the University of Cambridge and the Wellcome Sanger Institute.

Computer model shows how to better control MRSA outbreaks
A research team led by scientists at the Columbia University Mailman School of Public Health report on a new method to help health officials control outbreaks of methicillin-resistant Staphylococcus aureus, or MRSA, a life-threatening antibiotic-resistant infection often seen in hospitals.

Using MRSA's strength against it
MRSA evolved to become a deadly killer because it's wily and resilient.

Livestock-associated MRSAfound among MRSA from humans
The survey results show more frequent detections and geographical dispersion of LA-MRSA in humans in the EU/EEA since 2007, and highlight the public health and veterinary importance of LA-MRSA as a 'One Health' issue.

Fighting MRSA with new membrane-busting compounds
Public health officials are increasingly concerned over methicillin-resistant Staphylococcus aureus (MRSA).

Know thy enemy: Kill MRSA with tailored chemistry
UConn medicinal chemists have developed experimental antibiotics that kill MRSA, a common and often deadly bacteria that causes skin, lung, and heart infections.

MRSA uses decoys to evade a last-resort antibiotic
The superbug MRSA uses decoys to evade a last-resort antibiotic, reveals new research.

Scientists find a salty way to kill MRSA
Scientists have discovered a new way to attack Staphylococcus aureus bacteria.

Experimental antibiotic treats deadly MRSA infection
A new experimental antibiotic developed by a team of scientists at Rutgers University successfully treats the deadly MRSA infection and restores the efficacy of a commonly prescribed antibiotic that has become ineffective against MRSA.

OU team develops new antibiotic to fight MRSA
A University of Oklahoma team of chemists has developed a new antibiotic formulation to fight the sometimes deadly staph infection caused by methicillin-resistant S. aureus or MRSA and other antibiotic-resistant infectious bacteria.

Read More: MRSA News and MRSA Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.