Resistant MRSA Pneumonia Rates Rising in Children

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Pneumonia in children is most common in the winter and spring, but can happen anytime, particularly in children with compromised respiratory systems. Staphylococcus aureus is one of the most common bacteria causing pneumonia, with the rate in children doubling over the past decade. A study from the Texas Children’s Hospital also finds that the staph bacteria are becoming more and more resistant to two commonly used antibiotics – methicillin and clindamycin.

A team of researchers led by Dr. Maria A. Camillo-Marquez analyzed 117 children who were hospitalized with staph pneumonia at TCH between 2001 and 2009. They excluded children who had acquired pneumonia while on mechanical ventilation. The median age of the children was under one year and most of the children were previously healthy. Nearly 60% required treatment in the intensive care unit of the hospital.

Three-fourths of the infants were infected with methicillin-resistant Staphylococcus aureus bacteria. Most of the infections were from a particularly aggressive form of S. aureus called USA300. Children infected with this strain were more likely to have complicated pneumonia requiring video-assisted surgery (VATS) for diagnosis and treatment. In some cases, the bacteria were also resistant to clindamycin, a second-line antibiotic used to treat MRSA.

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Some of the children were also infected with the influenza virus, causing more severe pneumonia, higher rates of ICU care and respiratory failure. The children, on average, required three weeks of treatment with antibiotics. At the end of treatment, more than 80% were considered cured or improved.

Community-acquired MRSA is a growing concern in the United States. These infections occur in otherwise healthy people, particularly when in groups settings and sharing personal items such as athletes who share equipment or children in daycare facilities who share toys.

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Children at higher risk for developing pneumonia are those who were born premature, those exposed to second-hand smoke, or those with certain medical conditions such as asthma, sickle-cell disease, or heart defects. Malnutrition and compromised immune system also increase risk.

Symptoms of bacterial pneumonia include quick onset of a productive cough, pain in the chest, vomiting or diarrhea, decrease in appetite, and fatigue.

Journal Reference:
Carrillo-Marquez, Maria A. MD, et al. Staphylococcus aureus Pneumonia in Children in the Era of Community-acquired Methicillin-resistance at Texas Children's Hospital. Pediatric Infectious Disease Journal: July 2011 - Volume 30 - Issue 7 - pp 545-550
doi: 10.1097/INF.0b013e31821618be

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