MRSA Is on the Rise Among Children: Could Antibiotics Be to Blame?

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MRSA bacteria, colored scanning electron micrograph (SEM). Magnification: x5400.

Severe skin infections are increasing among children and becoming one of the most common reasons for hospitalization, a new study finds.

In 2009, about 71,900 children spent time in the hospital because of serious skin infections, a rate of 9.4 cases out of every 10,000 children — up from 4.5 cases per 10,000 children in 2000. By 2009, skin infections had become the seventh most common reason for hospitalization among children, moving up from the 13th spot in 2000.

The figures come from a new report from the Agency for Healthcare Research and Quality, which attributes the shift largely to a rise in methicillin-resistant Staphylococcus aureus (MRSA) infections. Although most cases of MRSA infection still occur in health-care settings like hospitals and nursing homes, an increasing number of infections are being spread in the community, particularly in locker rooms in schools, gyms and professional sports teams.

“I don’t think it’s really well appreciated that in most communities, community-acquired MRSA has become the dominant cause of soft tissue infection requiring emergency department care and inpatient care,” Dr. Patrick S. Romano, professor of medicine and pediatrics at the University of California, Davis, School of Medicine, told the New York Times. “People think of MRSA as a hospital bug, but it’s not just a hospital bug anymore. It’s a community bug.”

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According to a 2007 report from the Centers for Disease Control and Prevention, more than 95,000 people developed severe MRSA infections in 2005 and nearly 19,000 people died.

Evidence suggests that such superbugs are increasingly spreading in part because of overuse of antibiotics, which contributes to drug resistance. In line with that theory, a separate study of schoolchildren in England found that those who had been previously treated with antibiotics were more likely to be diagnosed with MRSA than children who had not used the medications.

Among a group of 297 children who tested positive for MRSA (it was unclear whether they had active infections or merely carried the bacteria on their skin) had been prescribed at least one antibiotic for an unrelated infection 30 to 180 days prior.

In contrast, 14% of 9,000 children who had been seen by the same pediatricians and did not have MRSA had received a prescription for antibiotics during the same time period.

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The more antibiotics children took, the higher the associated risk of being diagnosed with MRSA. Children who had received four prescriptions for antibiotics were 18 times more likely to receive a diagnosis of MRSA than children who did not take antibiotics, even after controlling for other medical conditions and stays in the hospital.

It bears noting, however, that the observational study does not prove cause and that nearly half of the children who carried MRSA had not taken any antibiotics at all.

MRSA infections can start out looking like a bug bite, pimple or blister, but may quickly progress into an abscess or pus-filled sore. Most infections can be treated without going to the hospital, but the longer parents wait to get their kids checked out, the greater the risk of complication. Reported the Times:

Most of the time, treatment can be handled at the doctor’s office or a clinic, and the child will be given oral antibiotics. Sometimes doctors may recommend warm compresses rather than medication, but if the infection doesn’t clear up within a day or two, the patient should see a doctor again, said Dr. Romano, an author of a June report in the journal Academic Pediatrics that also analyzed childhood hospitalization data.

Parents should talk to their pediatricians if they have concerns about overprescription of antibiotics and check with school administrators about MRSA risks at school. The best plan is vigilance: keep an eye on your child’s cuts and other skin injuries, since MRSA is passed through skin-to-skin contact and enters the body through open wounds.

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For more tips and information, have a look at the Mayo Clinic’s MRSA fact sheet.

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

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