An article in Pediatrics1 reports that the incidence of methicillin-resistant Staphylococcus aureus (MRSA) per 1,000 admissions to children's hospitals has increased 10-fold between 1999 and 2008, from 2 to 21 cases. Almost 30,000 children were admitted to the 25 children's hospitals studied and treated for MRSA, with 374 of the children reported to have died during hospitalization. The authors caution that MRSA was not the clear cause of death in all cases. However, 18,000 deaths in children and adults in the United States are attributed to MRSA each year. The study was limited to the incidence of admitting cases. The increase in deaths related to MRSA or the increase in severity of the infection were not examined.

Herigon et al1 also noted an increase in the use of clindamycin in association with the increased admission rate for MRSA. Unfortunately, clindamycin-resistant MRSA is emerging in some regions of the country. Vancomycin, given intravenously, was used in a decreased number of cases of MRSA evaluated for this study. Dr Kenneth Alexander, the pediatric infectious disease chief for the University of Chicago, notes "Staph are incredibly cagey and will ultimately find their way around any antibiotic in use." The authors of the study remind us that clindamycin needs to be used to treat only confirmed cases of MRSA in an effort to slow the incidence of clindamycin-resistant Staphylococcus.

In light of this report, nurse educators need to move away from teaching that MRSA is an infection that occurs in hospitals and nursing homes and emphasize that the bacteria is showing up throughout community settings. In fact, hospital-acquired MRSA seems to be declining, as community-acquired cases are on the increase.

References

1. Herigon J, Hersh A, Gerber J, Zaoutis T, Newland JH. Antibiotic management for Staphylococcus aureus infections in US children's hospitals, 1999-2008. Pediatrics. 2010;125:1294-1300. [Context Link]

Source: Tanner L. Dramatic surge seen in kids hospitalized with MRSA. May 17, 2010. The Miami Herald: Health AP. Available athttp://www.google.com/hostednews/ap/article/ALeqM5iRjX2lfHwiT-BJIbwtjFnIYiOYWwD9.Accessed May 18, 2010.

Submitted by: Robin Pattillo, PhD, RN, News Editor at[email protected].