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Methicillin-resistant Staphylococcus aureus at children's hospitals in the United States
Abstract:
Although methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in hospitalized adults in the United States, reports of MRSA in pediatric patients have been infrequent. To determine the frequency at which MRSA is isolated from children, we surveyed the directors of microbiology at all acute care children's hospitals in the United States, and 57 of 67 (85%) laboratory directors responded to a mailed questionnaire. Those not testing S. aureus for methicillin susceptibility were excluded from the analysis. Of 53 (57%) laboratory directors 30 reported that MRSA had been isolated from patients in their hospitals. Between 1973 and 1981 the proportion of hospitals isolating MRSA increased significantly; 1 of 53 hospitals reported MRSA in 1973 compared to 20 of 53 hospitals in 1981 (P less than 0.001). Large hospitals (greater than or equal to 200 beds) reported MRSA isolates more frequently than did small hospitals (less than 200 beds) (P = 0.007). No association was found between the isolation of MRSA and the presence of burn or intensive care units, residency training programs or rotation of residents to other hospitals. MRSA isolation varied by standard metropolitan statistical area and geographic region. These data show that the isolation of MRSA is increasing in frequency in pediatric patients and that the reporting of MRSA from children's hospitals varies by hospital size, standard metropolitan statistical area and region. Since MRSA causes significant morbidity and mortality, further studies are necessary to identify the risk factors for MRSA infections and to develop effective control measures.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly isolated from pediatric patients in US children's hospitals. This trend highlights a growing concern for pediatric infectious disease management and control strategies.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in adult hospital settings.
- Reports of MRSA infections in pediatric populations have historically been infrequent.
- Understanding MRSA prevalence in children is crucial for public health.
Purpose of the Study:
- To determine the frequency of MRSA isolation in pediatric patients across US acute care children's hospitals.
- To analyze trends in MRSA isolation rates over time.
- To identify factors associated with MRSA detection in pediatric facilities.
Main Methods:
- A mailed questionnaire survey was distributed to directors of microbiology at US acute care children's hospitals.
- Laboratory directors were asked about MRSA isolation from patients between 1973 and 1981.
- Data analysis focused on hospitals testing *S. aureus* for methicillin susceptibility.
Main Results:
- 30 out of 53 responding laboratories reported isolating MRSA from pediatric patients.
- A significant increase in MRSA isolation was observed from 1973 (1/53 hospitals) to 1981 (20/53 hospitals).
- Larger hospitals (≥200 beds) reported MRSA more frequently than smaller hospitals (<200 beds).
Conclusions:
- MRSA isolation is increasing in frequency among pediatric patients in the United States.
- The reporting of MRSA varies by hospital size, geographic region, and metropolitan statistical area.
- Further research is needed to identify pediatric MRSA risk factors and develop effective control measures.