Study shows children's MRSA-related pneumonia rates on the rise

An aggressive strain of methicillin-resistant Staphylococcus aureus (MRSA) caused pneumonia in a majority of the children at Texas Children’s Hospital, according to a new study. The antibiotic clindamycin was used effectively in most of the pneumonia cases.

For the study, which was published in the July issue of The Pediatric Infectious Disease Journal, researchers with Texas Children’s Hospital analyzed the cases of 117 children hospitalized with Staphylococcus aureus (SA) pneumonia between 2001 and 2009. The children’s median age was under 1 year.

The researchers’ analysis of the bacteria found that three-fourths of the infants were infected with MRSA, which has become resistant to the standard antibiotics used to treat staph infections. The remaining infections were caused by antibiotic-susceptible S. aureus. Most of the children with MRSA (90%) were infected with USA300, an aggressive strain of S. aureus, and were resistant to antibiotics.

Clindamycin alone or in combination was used as the definitive therapy in 75% of the patients and as empirical treatment in 31%. Nearly 80% of patients received vancomycin as part of their empirical antibiotic therapy, generally for between 2 and 4 days. Vancomycin was discontinued once S. aureus was identified.

In addition, video-assisted thoracoscopy (VATS) occurred in 76% of cases. “VATS was more commonly used for USA300 infections, compared with non-USA300 outcomes,” the researchers wrote. Eighty-eight percent of patients were cured or improved after treatment; 1 patient died.

The researchers concluded that clindamycin is an effective antibiotic to complete therapy for SA pneumonia, adding, “Further studies are needed to determine the optimal antibiotic therapy for SA pneumonia in children.”