Methicillin resistant staphylococcus aureus bacteraemia (MRSA)
Surveillance of Methicillin-Resistant Staphylococcus Aureus (MRSA) bacteraemia in children occurred from June 2005 to June 2007. At the time of surveillance, routine national surveillance had been analysed and identified a potentially worrying increase in MRSA bacteraemia in children. The number of reported cases rose from four in 1990 to 77 in 2000. This study aimed to obtain a robust estimate of the incidence of MRSA bacteraemia in children and to define the demographic and clinical features to identify those children at high risk.
Lead investigator
Dr AP Johnson
About the study
Analysis of data obtained through routine national surveillance identified a potentially worrying increase in Methicillin-Resistant Staphylococcus Aureus (MRSA) bacteraemia in children, with the number of reported cases rising from four in 1990 to 77 in 2000.1 Fifty-three per cent of the 376 cases reported between 1990 and 2001 involved infants less than 12 months of age, substantial numbers of infected infants aged one to four years were also reported. This data were from voluntary reporting and were likely to have reflected an under-estimate of the true incidence of infection.
The aims of this study were to obtain a robust estimate of the incidence of MRSA bacteraemia in children, and to define the demographic and clinical features to identify those children at high risk.
Isolates of MRSA from children were characterised by their antibiotic resistance pattern, strain type and biological properties (particularly virulence traits). Possible associations between organism type and clinical features of infection were investigated.
This study had indicated that in the UK, the majority of isolates were hospital strains in contrast to the changing epidemiological picture seen in other countries, particularly the USA, where high levels of community-associated infections have emerged. These findings had significant relevance for the management and control of severe paediatric infections due to S. aureus.
The study aimed to determine:
- The incidence of MRSA bacteraemia in children aged <16 years.
- Whether the incidence of MRSA bacteraemia varies by age.
- The spectrum of clinical features and patterns of presentation of MRSA bacteraemia in children.
- Whether MRSA bacteraemia in children was mainly due to health care or community-associated MRSA, and whether acquired nosocomially or in the community.
- Whether cases of MRSA bacteraemia in children tend to occur in particular hospital units or specialities.
- Whether strains of MRSA that cause bacteraemia in children have particular biological characteristics. In particular, are the isolates similar to those found in hospitalised adults? Are the isolates representative of true community-associated MRSA reported in the UK and other countries? Do the strains possess particular virulence traits, such as Panton-Valentine leukocidin?
Duration
June 2005 – June 2007
Published papers
Johnson AP, Sharland M, Goodall CM, Blackburn R, Kearns AM, Gilbert R, Lamagni TL, Charlett A, Ganner M, Hill R, Cookson B, Livermore D, Wilson J, Cunney R, Rossney A, Duckworth G. Enhanced surveillance of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia in children in the UK and Ireland. Arch Dis Child. 2010 Oct;95(10):781-5. doi: 10.1136/adc.2010.162537. Epub 2010 Jun 1. Erratum in: Arch Dis Child. 2011 Jun;96(6):e1. PMID: 20515969.
BPSU 22nd Annual report 2007 -2008