Less Fatal MRSA Blood Infections in Children Could Develop Significant Complications

Highlights

• Methicillin-Resistant Staphylococcus Aureus (MRSA) infections are an on going health problem.
• Children with MRSA blood infections are less likely to die but may have significant complications, finds a study.

Blood stream infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) in children are less fatal than adults. They may even have different risk factors for treatment failure, finds a new study from the Children’s National Health System. Methicillin-resistant Staphylococcus Aureus (MRSA) infections are an on going health problem. MRSA infections in the blood stream could cause numerous complications that would kill about 10-30% of the patients.

Superbugs may result in more than 80,000 infections and more than 11,000 deaths every year in the United States.

The younger patients may also have a high rate of complications which could increase the infections that are untreated, this could highlight the need for effective treatment.

Rana F. Hamdy, M.D., M.P.H., M.S.C.E., attending physician in the Division of Infectious Diseases, Director of the Antimicrobial Stewardship Program at Children’s National and lead study author said, "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."

Research Study
The research team also studied the outcomes of children with MRSA bacteremia or infections in patients who were younger than 18 from three children’s hospitals.

All the 232 patients had positive blood cultures for MRSA and were hospitalized at centers in Philadelphia, Baltimore and Salt Lake City from 2007-2014.

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The findings were based on the electronic health records of the pediatric patients. The research team gathered data on how many patients died, had infections, were not adequately controlled or developed complications from infections. This was also helpful to understand the risk factors that led to treatment failure.

Study Findings
The study results showed that only 2% of the children died due to the infections. But, around one-quarter of them developed serious complications that include blood clots caused by an immune response to the infection or infection which could spread to other sites such as the heart.

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The duration of the infection in children was two days when compared to adults in whom it was seven days. The research team also found that the risk of developing the complication also rose by around 50% in kids.

About one-third of the children experienced treatment failure, which was defined by bacteremia that lasted for more than three days. The risk of treatment failure was greatest among adults with low concentrations of vancomycin or heart infections.

However, in children the treatment failure may occur due to MRSA infections in the muscles, bones or blood vessels. Vancomycin concentrations may appear to have a little bearing effect on treatment failure in children.

Dr. Hamdy added, "This is an important finding."

"In order to achieve high concentrations of vancomycin, children are given high doses. 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."

The research team also noted that the findings might underscore the need to better understand clinical characteristics and outcomes specific to children. Further studies may help to determine the vancomycin dose, duration and approach of monitoring the concentrations and could help to optimize the patient outcomes.

"This was the first step, but additional data are needed," said Dr. Hamdy.

"Future studies should pinpoint exact concentrations of vancomycin we should achieve in children so that the medicine clears infections effectively without causing additional harm."



Source-Medindia