Year: 2024
Type: article
Abstract: Infection prevention practices for methicillin-resistant Staphylococcus aureus (MRSA) in hospitalized children have their roots in adult medicine.Over the past several decades, MRSA infections have posed an increasing burden to hospitalized adults 1-3 and children.4,5 From health care-associated infections (HAIs) to increasing prevalence of community-acquired infections, MRSA continues to be a challenging pathogen across health care systems, with rates of MRSA HAIs ranging from 42% to 56% in adult populations. 1 Because of steadily increasing MRSA infection rates, in 2001, the Veterans Affairs (VA) Pittsburgh Healthcare system was one of the first to create a "MRSA bundle" with the goal of eliminating health care-associated MRSA infections.The MRSA bundle included universal nasal surveillance bacterial culture for MRSA colonization at hospital admission, at transfer to another unit, and at discharge; hand hygiene initiatives; contact precautions for patients found to be MRSA carriers; and institutional culture change with infection control initiatives intended to make providers proactive participants in interrupting MRSA transmission and infection.6 The MRSA bundle intervention decreased health care-associated MRSA infection rates in ICUs by 62% and in non-ICU settings by 45%.6 A subsequent study within the broader VA system showed that MRSA nasal screening also demonstrated an overall negative predictive value (NPV) for ruling out MRSA infections of 96.5% at hospital admission.7 Subsequent studies in non-VA and VA adult hospitals have shown similar high NPVs (94%-98% for pneumonia, 90%-95% for blood stream infections, 83%-97% in intraabdominal infections, 98.1% of skin and soft tissue infections, and 98.4% of urinary tract infections).8,9 Studies in adults highlight the potential to incorporate MRSA screening as an antimicrobial stewardship tool for reducing empirical anti-MRSA therapy or for rapidly deescalating from anti-MRSA therapy.8,10 It is only logical to assume that extending MRSA screening to pediatric acute and critical care settings would have similar positive impacts on hospitalized children.The current study by Mannheim et al seeks to help answer the question, "When should I screen my pediatric patient for MRSA?" 11 Interpreting their findings requires appreciation of how MRSA surveillance testing has translated into emergency and inpatient pediatric settings.Today, MRSA surveillance screening is commonplace in pediatric settings.Multiple previous reports highlight the benefits of screening for infants and children seen in emergency departments, NICUs, PICUs, and inpatient
Source: Hospital Pediatrics
Institution: University of Nebraska Medical Center
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4391107677