MRSA Cases Up 10-Fold (1999-2008) Study

[Missouriwatcher]

"The number of children hospitalized with dangerous drug-resistant staph infections surged 10-fold in recent years, a study found. Disease incidence increased from 2 cases to 21 cases per 1,000 hospital admissions from 1999 to 2008. Most infections were caught in the community, not in the hospital..."

http://www.kctv5.com/health/23575983/detail.html

Antibiotic Management of Staphylococcus aureus Infections in US Children's Hospitals, 1999?2008 (Pediatrics)
"Conclusions Antibiotic prescribing patterns for the treatment of S aureus infections have changed significantly during the past decade, reflecting the emergence of community-associated MRSA. Clindamycin is now the most commonly prescribed antibiotic for S aureus infections among hospitalized children. The substantial use of clindamycin emphasizes the importance of continuous monitoring of local S aureus susceptibility patterns."

http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-2867v1?maxtoshow=&hits=10&RESULTFORMAT=&fulltext=mrsa&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

[sharon sanders]

Re: MRSA Cases Up 10-Fold (1999-2008) Study

Articles

Antibiotic Management of Staphylococcus aureus Infections in US Children's Hospitals, 1999?2008

<nobr>Joshua C. Herigon, MPH^a^,b</nobr>, <nobr>Adam L. Hersh, MD, PhD^c</nobr>, <nobr>Jeffrey S. Gerber, MD, PhD^d</nobr>, <nobr>Theoklis E. Zaoutis, MD, MSCE^d</nobr>, <nobr>Jason G. Newland, MD^a^,b</nobr>
^aChildren's Mercy Hospital and Clinics,
^bDepartment of Pediatrics, Section of Infectious Diseases, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri;
^cDivision of General Pediatrics, University of California, San Francisco, San Francisco, California; and
^dDivision of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Objectives The objective of this study was to describe trends in antibioticmanagement for Staphylococcus aureus infections among hospitalizedchildren from 1999 to 2008.
Methods A retrospective study was conducted by using the Pediatric HealthInformation Systems database to describe antibiotic treatmentof inpatients with S aureus infection at 25 children's hospitalsin the United States. Patients who were admitted from 1999 to2008 with International Classification of Diseases, Ninth Revision,Clinical Modification codes for S aureus infection were included.Trends in the use of vancomycin, clindamycin, linezolid, trimethoprim-sulfamethoxazole,cefazolin, and oxacillin/nafcillin were examined for percentageuse and days of therapy per 1000 patient-days.
Results A total of 64813 patients had a discharge diagnosis for S aureusinfection. The incidence of methicillin-resistant S aureus (MRSA)infections during this period increased 10-fold, from 2 to 21cases per 1000 admissions, whereas the methicillin-susceptibleS aureus infection rate remained stable. Among patients withS aureus infections, antibiotics that treat MRSA increased from52% to 79% of cases, whereas those that treat only methicillin-susceptibleS aureus declined from 66% to <30% of cases. Clindamycinshowed the greatest increase, from 21% in 1999 to 63% in 2008.Similar trends were observed by using days of therapy per 1000patient-days.
Conclusions Antibiotic prescribing patterns for the treatment of S aureusinfections have changed significantly during the past decade,reflecting the emergence of community-associated MRSA. Clindamycinis now the most commonly prescribed antibiotic for S aureusinfections among hospitalized children. The substantial useof clindamycin emphasizes the importance of continuous monitoringof local S aureus susceptibility patterns.


Key Words: Staphylococcus aureus ? epidemiology ? pediatric ? antibiotic use
Abbreviations: SSTI = skin and soft tissue infection ? MRSA = methicillin-resistant Staphylococcus aureus ? CA-MRSA = community-associated MRSA ? MSSA = methicillin-susceptible S aureus ? TMP/SMX = trimethoprim/sulfamethoxazole ? PHIS = Pediatric Health Information System ? CHCA = Child Health Corporation of America ? ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification ? DOT = days of therapy

<hr align="left" width="50%" noshade="noshade" size="1"> Accepted Feb 22, 2010.