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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Increasing use of extracorporeal life support in methicillin-resistant Staphylococcus aureus sepsis in children

C Buddy Creech1, B Gayle Johnson, Randall E Bartilson

  • 1Pediatric Infectious Diseases and Pediatric Clinical Research Office, Vanderbilt University Medical center and Children's Hospital, Nashville, TN, USA. buddy.creech@vanderbilt.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|April 10, 2007
PubMed
Abstract

Insights

The use of extracorporeal life support (ECLS) for pediatric methicillin-resistant Staphylococcus aureus (MRSA) infections is increasing. High mortality rates in older children with MRSA infections requiring ECLS are a growing concern.

Area of Science:

  • Pediatric Critical Care Medicine
  • Infectious Diseases
  • Extracorporeal Membrane Oxygenation (ECMO)

Background:

  • Fulminant community-associated methicillin-resistant Staphylococcus aureus (MRSA) infections in children can be severe.
  • The frequency of extracorporeal life support (ECLS) use for severe pediatric staphylococcal disease is not well-documented.

Observation:

  • A study analyzed pediatric ECLS cases for MRSA infections from 1994-2005 using local and international databases.
  • Demographic data, ventilatory management, and cardiopulmonary status were assessed for children (0-18 years) with MRSA infections requiring ECLS.

Findings:

  • Three MRSA sepsis cases requiring ECLS were identified locally since 2000, all in previously healthy adolescents with severe necrotizing pneumonia; two patients died.
  • Internationally, 45 pediatric MRSA infection cases requiring ECLS were identified, with nearly half reported in the two years prior to the study.
  • Survival rates for MRSA infection requiring ECLS varied by age, with infants and young children (1-4 years) having the highest survival (65-71%) and older children (5-9 and 13-18 years) having the lowest (0-31%).

Implications:

  • The incidence of ECLS use for pediatric MRSA infections is rising globally.
  • High mortality rates, especially in older pediatric patients with MRSA infections requiring ECLS, underscore the increasing threat posed by this pathogen.

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