MRSA Infections Spreading to Kids in Community

Antibiotic-resistant bacteria moving beyond hospital setting, study finds

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HealthDay Reporter

MONDAY, Jan. 19, 2009 (HealthDay News) -- Antibiotic-resistant infections around the head and neck are on the rise among American children, a new report indicates.

The finding suggests that tougher strains of the bacteria Staphylococcus aureus -- referred to as MRSA because of their resistance to the antibiotic methicillin -- are moving beyond the traditional confines of hospitals and into the community at large.

"We certainly found that the emergence of resistant staph head and neck infections in pediatric settings is on the rise," said study co-author Dr. Steven E. Sobol, director of the department of pediatric otolaryngology at the Emory University School of Medicine in Atlanta.

Sobol and his colleagues reported the findings in the January issue of the Archives of Otolaryngology Head & Neck Surgery.

The building threat to children compounds a trend toward more community-based MRSA infections previously observed among prison, nursing home, and chronically ill patient populations, the researchers noted.

In the latest study, the authors reviewed data concerning pediatric infections that had been collected between 2001 and 2006 in a national database that amasses anti-microbial drug resistance test results from labs working for more than 300 hospitals across the country.

The research team found that of the more than 21,000 infections that had occurred among children during the study period, almost 22 percent were resistant to the antibiotic methicillin. Overall, MRSA head and neck infection rates had more than doubled, from about 12 percent to just over 28 percent.

About one-third of MRSA infections affected the ears, while about 28 percent impacted the nasal and sinus regions. Head and neck MRSA infections accounted for about 14 percent of the total.

Sobol stressed, however, that the apparent rising MRSA risk to children is not yet cause for alarm.

"I don't want to generate panic," he said. "And really, there's no reason for parents and children to change their lives. Reducing risk for infection is all about common sense and practicing normal hygienic measures, such as encouraging children to wash their hands and avoid contact with other ill children in crowded situations."

"But it's also important that pediatricians recognize the importance of this and suspect the possibility among children who don't respond to normal measures taken to deal with a cold or infection," he said. "And certainly, when a normal infection or cold seems worse than a parent would expect it to be, then parents should seek medical attention from their pediatrician quickly. Don't panic. Just be aware."

"Meanwhile, the underlying cause for the rise in pediatric infections is the subject of ongoing study at our institution, because we don't yet know exactly why it's occurring," Sobol acknowledged. "But we suspect is that it's due to a combination of factors."

Dr. Philip Tierno, director of clinical microbiology and immunology at New York University Medical Center, agreed.

"On the one hand, it could be that physicians might be less cautious in their use of antibiotics when it comes to children," he noted. "This is even though the American Pediatric Association has really come out strongly for physicians to be careful with administration of antibiotics to children. It also could, in part, be that we're simply monitoring case trends better than we had in the past, and so we're finding it in greater numbers among children than before."

But Tierno hypothesized that MRSA is simply on the rise outside traditional hospital settings.

"I suspect," added Tierno, "that the primary reason children might be more likely to come down with a MRSA in the community is that the community is now a reservoir for antibiotic-resistant organism, whereas before it was primarily just the hospital. And so, children just reflect that shift as a significant part of the community."

More information

For more on MRSA, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: Steven E. Sobol, M.D., director, department of pediatric otolaryngology, Emory University School of Medicine, Atlanta; Philip Tierno, M.D., Ph.D., director, clinical microbiology and immunology, New York University Langone Medical Center, and author, The Secret Life of Germs and Protect Yourself Against Bioterrorism; January 2009, Archives of OtolaryngologyHead & Neck Surgery

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