[Should children adopted from abroad be screened for methicillin-resistant Staphylococcus aureus?]

Patients with increased risk of colonisation with Methicillin-resistant Staphylococcus aureus (MRSA) are screened before admission to hospitals in Norway. Denmark and the Netherlands have introduced routine screening of all children adopted from abroad before hospital admission. The present study aims at identifying whether children adopted to Norway had a higher risk of being MRSA-positive than other children of the same age.

Incidence rates and relative risks for MRSA-infections or colonisation were calculated for children adopted from abroad and for other children. Data from Statistics Norway and the Norwegian Surveillance System for Communicable Diseases (MSIS) were used.

The incidence rate for confirmed MRSA-infection in children < 3 years of age adopted from abroad was 1.1 per 1,000 person year, and that for other children was 0.034 per 1,000 person year in the period 1995-2005. In this period, adopted children had 33 times increased risk of being notified with MRSA-infection. In 2005, the incidence rate for detected colonisation with MRSA was 3.7/1,000 person year for adopted children and 0.053/1,000 person year for other children; i.e. in this year the risk of being found colonised with MRSA was 70 times higher for children adopted from abroad than for others.

Norwegian hospitals should introduce screening for MRSA at hospital admission as a routine for children adopted from abroad during the last 12 months. The National Institute of Public Health should continue to survey the incidence of MRSA among groups in the population and prospectively change the recommendations for MRSA-screening according to new knowledge.