MRSA infections are becoming increasingly common in children, and now account for one in five community-acquired staphylococcus aureus infections treated in hospitals, Sydney researchers have shown.
In a review of 403 children presenting with community-acquired S. aureus infection at the Children's Hospital at Westmead, Sydney, paediatricians found 19% were caused by MRSA.
MRSA infections were strongly linked with more serious skin and soft tissue infection with abscess formation, the researchers report in the Journal of Paediatrics and Child Health.
In contrast, MRSA infections were less likely to be to be associated with simple skin and soft tissue such as infected nappy rash, eczema and paronychia.
Community acquired MRSA infections were also more likely to cause invasive bone and joint infections and the researchers said this was in line with other studies showing that MRSA infections overall produced more invasive disease, and more severe disease with higher rates of admission, longer length of stay and a higher rate of intensive care admission.
Aboriginal background was associated with an increased risk of MRSA infection, but unlike previous studies there was no increased risk with Pacific Islander or Maori ethnicity.
The researchers said this may mean that assumptions about imported MRSA in these populations no longer hold true.
Other risk factors associated with MRSA infection included a family history of staphylococcal infection or skin and soft tissue infections, recent use of anti-staph antibiotics and age over one year old.
Their study found that 12% of MRSA infections showed resistance to sulfamethoxazole-trimethoprim and 16% showed resistance to erythromycin.
The researchers conclude that their findings show "the highest published rate of community-acquired-MRSA among children in Australia," and also provide point of care identifiable features that may be useful predictors of MRSA infection.
By Michael Woodhead