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Updated: Jun 14, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Community-associated methicillin-resistant Staphylococcus aureus strains in pediatric intensive care unit
Aaron M Milstone1, Karen C Carroll, Tracy Ross
1Department of Pediatric Infectious Diseases, The Johns Hopkins University School of Medicine, 200 N Wolfe St, Rubenstein 3141, Baltimore, MD 21287, USA. amilsto1@jhmi.edu
Abstract:
Virulent community-associated methicillin-resistant Staphylococcus-aureus (CA-MRSA) strains have spread rapidly in the United States. To characterize the degree to which CA-MRSA strains are imported into and transmitted in pediatric intensive care units (PICU), we performed a retrospective study of children admitted to The Johns Hopkins Hospital PICU, March 1, 2007-May 31, 2008. We found that 72 (6%) of 1,674 PICU patients were colonized with MRSA. MRSA-colonized patients were more likely to be younger (median age 3 years vs. 5 years; p = 0.02) and African American (p<0.001) and to have been hospitalized within 12 months (p<0.001) than were noncolonized patients. MRSA isolates from 66 (92%) colonized patients were fingerprinted; 40 (61%) were genotypically CA-MRSA strains. CA-MRSA strains were isolated from 50% of patients who became colonized with MRSA and caused the only hospital-acquired MRSA catheter-associated bloodstream infection in the cohort. Epidemic CA-MRSA strains are becoming endemic to PICUs, can be transmitted to hospitalized children, and can cause invasive hospital-acquired infections. Further appraisal of MRSA control is needed.
Insights
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly found in pediatric intensive care units (PICUs). These virulent strains can be transmitted to hospitalized children and cause invasive infections, necessitating enhanced control measures.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains exhibit high virulence and have spread rapidly.
- Understanding the epidemiology of CA-MRSA within pediatric intensive care units (PICUs) is crucial for infection control.
Purpose of the Study:
- To investigate the importation and transmission dynamics of CA-MRSA in a pediatric intensive care unit.
- To determine the genotypic characteristics of MRSA strains colonizing and infecting patients in the PICU.
Main Methods:
- Retrospective study of patients admitted to The Johns Hopkins Hospital PICU from March 2007 to May 2008.
- MRSA colonization screening and genotypic fingerprinting of MRSA isolates.
- Analysis of patient demographics and risk factors associated with MRSA colonization.
Main Results:
- 72 (6%) of 1,674 PICU patients were colonized with MRSA.
- MRSA colonization was associated with younger age, African American ethnicity, and prior hospitalization.
- Genotyping revealed that 61% of MRSA isolates were CA-MRSA strains, which were also responsible for the sole hospital-acquired MRSA bloodstream infection.
Conclusions:
- Epidemic CA-MRSA strains are becoming endemic in PICUs.
- CA-MRSA can be transmitted among hospitalized children and lead to invasive infections.
- There is a need for further evaluation and implementation of MRSA control strategies in PICUs.
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