MRSA is less fatal in kids but can cause serious complications

Children with bloodstream infections caused by the superbug MRSA, a common antibiotic-resistant bacteria, are less likely to die than adults with this condition but can suffer serious complications.

MRSA stands for meticillin-resistant Staphylococcus aureus. Staphylococcus aureus is a bacteria or germ that many people carry in their nose or on their skin. 'Meticillin-resistant' means the bacteria cannot be killed by meticillin, a type of antibiotic that used to be able to kill them. In a report into the superbug, the Health Service Executive stated that the prevention and control of MRSA is a public health challenge that has been prevalent in many Irish hospitals since the early 1970s. In adults, MRSA infections that reach the bloodstream are responsible for numerous complications and fatalities. Although research into adult patients has guided paediatric treatment recommendations for years, little has been known about how this condition might uniquely affect children. Now, a new study by a leading American paediatric infectious disease specialist Dr Rana Hamdy, has shown that children have high rates of complications from MRSA, that increase significantly each day infections linger, highlighting the urgent need for effective intervention and treatment. Dr Hamdy says that understanding the potential complications is key:

"Knowing that the risk of complications increases with every additional day the bacteria are detected in the bloodstream highlights the importance of early and aggressive therapy for these infections."

Dr Hamdy says her research has shown that, unlike adults, who commonly experience hospital-acquired infections, in children almost 80 percent of MRSA infections are community acquired. Using paediatric patients' electronic health records, the researchers looked at how many patients had died, had infections that were not adequately controlled, or who developed complications from their infections. They also used this information to better understand risk factors that led to treatment failure. Thankfully, their results showed that only 2 percent of paediatric patients died from their infections. However, about one-quarter developed serious complications, including blood clots caused by an immune response to the infection or infection that spread to organs, such as the heart. With each passing day, the researchers found, the risk of developing a complication rose by 50 percent for kids.

"This is an important finding" Dr Hamdy adds, "in treatment children are given high doses of the antibiotic vancomycin. These high doses, however, can be associated with kidney injury. If there is no clear benefit in clearing the bacterial infection, these high doses may place children at risk unnecessarily. This was the first step, but additional research is needed. Future studies should pinpoint the exact concentrations of vancomycin we should achieve in children so that the medicine clears infections effectively without causing any additional harm."

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