Johns Hopkins finding more MRSA in kids
Researchers at Johns Hopkins Children's Center have found that more kids are coming in with community-aquired MRSA, the super bug that is often resistent to antibiotics.
The kids aren't always sick from MRSA, but are carriers who pose a threat to other patients.
The researchers have found that screening all patients as they come into the ICU and then every week is helpful in controlling the spread.
The researchers said it was once very uncommon for kids to come in with community-acquired infections with the drug-resistent strains of the bacterium Staphylococcus aureaus. But the findings, to be published in the April edition of the journal Emerging Infectous Diseases, show that the Hopkins policy of screening everyone is beneficial.
This infection causes skin and soft-tissue infections, but in sick people or those with compromised immune systems, it can be deadly.
The Johns Hopkins Hospital began screening all patients in 2007 regardless of symptoms.
“MRSA has become so widespread in the community, that it’s become nearly impossible to predict which patients harbor MRSA on their body,” said lead investigator Dr. Aaron Milstone, a pediatric infectious disease specialist at Hopkins Children’s, in a statement.
“Point-of-admission screening in combination with other preventive steps, like isolating the patient and using contact precaution, can help curb the spread of dangerous bacterial infections to other vulnerable patients.”
The hopkins study found 6 percent of the 1,674 children admitted to the pediatric ICU at Hopkins Children’s between 2007 and 2008 carried MRSA but had no active infection. Of the 72 who tested positive, 60 percent had the community-acquired strain and 75 percent of the carriers had no history of MRSA. It was more common in kids 3 years old on average, and among African-American children, though researchers don't know why. Eight patients acquired MRSA while in the ICU, with 4 developing signs of infection.
The research was funded in part by the National Institutes of Health, the Thomas Wilson Sanitarium for Children in Baltimore and by the Centers for Disease Control and Prevention. Other investigators in the study included Dr. Karen Carroll, Tracy Ross, Alexander Shangraw and Dr. Trish Perl, all of Hopkins.
Comments
While the conclusion of this study sounds good, the truth is that this is just another in an already long list of studies (more than 150 of them) that confirm--not just support--that active detection and isolation (ADI), if done properly, works in controlling hospital-spread MRSA. While MRSA is not the only bug that is circulating in healthcare institutions, it is indisputably the most common. Which begs the question: Why do we need more studies before all institutions are not routinely using ADI and therefore protecting patients from this decades long scourge that has taken countless lives and caused untold suffering unnecessarily? And why has Hopkins and other Maryland hospitals, been opposed to all hospitals and nursing facilities doing the same? Are the politics of medicine and the money for studies more important than the lives of patients?
Posted by: Michael Bennett | March 27, 2010 11:06 PM
I've read this study and have come to the conclusion that the big elephant in the room is how hospitals have failed to implement the most basic methods of protecting patients from harm and untimely death from MRSA infections.
A simple nasal swab (just like the cervical ones they do on ALL pregnanat women in the last trimester of pregnancy to screen for Group B strep) could quickly identify those who are carrying it into the hospital, and those who become infected in the hospital.
By NOT carrying out the basic principles of ADI, hospitals are playing a dangerous game of roullette...basing the risk of picking up these deadly infections on the chances of good handwashing.
Screening before or on admission with simple nasal swabs would result in identifying the carriers, isolating them from others, decolonizing them and treating them with appropriate antibiotics.
These are basic principles of disease prevention. So why aren't ALL hospitals doing it? Why isn't our government mandating it? Why isn't the CDC and The Joint Commission requiring this as the standard of care? The evidence is overwhelming.
The only logical answer is that hospital lobbying is winning over the basic rights of patients.
Posted by: Lori Nerbonne | April 9, 2010 12:45 PM