May 17, 2010

MRSA Infections In Children Growing

A study recently published has found that the number of children hospitalized with dangerous drug-resistant staph infections surged 10-fold in recent years.

The study showed that disease incidence increased from 2 cases to 21 cases per 1,000 hospital admissions from 1999 to 2008.  Most of the infections were caught in the community, not in the hospital.

The study involved methicillin-resistant infections, called MRSA.  These used to occur more often in hospitals and nursing homes, but they are increasingly showing up in other settings.  Recent evidence suggests hospital-acquired MRSA cases may be declining while community-acquired cases are becoming more common.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University, told the Associated Press (AP) that the results are "a good example of how something that is not unexpected remains alarming."  He was not involved in the study.

The study looked at 25 children's hospitals, but lead author and an infectious disease physician at Children's Mercy Hospitals and Clinics and the University of Missouri-Kansas City told AP that the 10-fold increase in hospitalizations likely occurred nationwide.

About 30,000 children were hospitalized with MRSA infections at the hospitals studied during the 10-year period.  Most of the children had skin or muscle infections, and 374 died.  Although Newland said he is not clear if MRSA caused those deaths, it can be deadly and is blamed for over 18,000 deaths in children and adults nationwide every year.

The study did not examine whether deaths or the severity of infections increased.

The study was published Monday in the journal Pediatrics.

MRSA often starts as a pimple or boil on the skin.  It can spread to other parts of the body, like the lungs or bones.

The study also discovered a coinciding increase in use of clindamycin, an antibiotic that comes in easy-to-use pills and liquid, along with smaller increases in two other antibiotics.  The drug vancomycin is another drug effective against MRSA, and its use decreased during the study.

Newland said the increasing use of clindamycin is concerning because in some regions MRSA is already becoming resistant to the drug.  He said that doctors should use the antibiotic judiciously.

Dr. Kenneth Alexander, the University of Chicago's pediatric infectious disease chief, told AFP that he agrees.

"Staph are incredibly cagey, and will ultimately find their way around any antibiotic in use," he said.

Alexander told AP that research is needed to find other drugs that will work against MRSA.


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