Recognizing MRSA characteristics key to treating cervical infections

McCormick ME. JAMA Otolaryngol Head Neck Surg. 2013;doi:10.1001/jamaoto.2013.1234.

  • January 22, 2013

Becoming familiar with characteristics associated with methicillin-resistant Staphyloccus aureus infections in children may lead to improved care for these patients, according to study findings published online.

Michael E. McCormick, MD, of the department of otolaryngology at the Medical College of Wisconsin, Milwaukee, and colleagues published findings from a retrospective review of children who were seen at any of the 4,100 hospitals in the Kids’ Inpatient Database and had a code entered for MRSA, as well as specific head and neck infections.

 

Michael E. McCormick

The researchers found nearly 27,000 MRSA admissions overall; and of these, 3,571 included a head and neck infection.

McCormick and colleagues noted certain patterns among children with MRSA; specifically, that the mean age at admission was 7.72 years, and most of the patients were in lower income homes. Nonwhite race was also associated with longer hospitalizations, according to the study findings.

Younger children were more likely to be hospitalized longer and require surgical drainage.

“This association can potentially be explained by the smaller size of children’s necks and airways, and a lower threshold for intervention may exist among otolaryngologists treating these patients,” the researchers wrote, adding that surgical drainage procedures could naturally prolong a patient’s hospitalization.

“Our study is a small part of an ongoing nationwide effort to improve the utilization of our health care resources. We feel that knowledge of risk factors and disease patterns can improve physicians’ abilities to provide both excellent and cost-effective care,” McCormick told Infectious Diseases in Children. “MRSA is a global problem, and its significance in our country’s pediatric community continues to grow. Accurate diagnosis and prompt treatment of children with MRSA neck infections will help optimize their care.”

Disclosure: McCormick reports no relevant financial disclosures.

Michael E. McCormick, MD, can be reached at mmccormick@mcw.edu.

Perspective
C. Buddy Creech, MD, MPH

C. Buddy Creech

  • Appropriate resource utilization is an important service we provide for hospitalized patients. Anticipating who will need more aggressive intervention, planning for those whose lengths of stay may be significantly longer, and knowing a priori our patients' barriers to efficient care are key to allocating these resources. While the study by McCormick and colleagues may raise as many questions as it sought to answer, providing a sense of the national average for length of stay, hospital charges, and risk factors for deviation from this norm are helpful additions to our understanding of pediatric MRSA head and neck infections.

    • C. Buddy Creech, MD, MPH
    • Infectious Diseases in Children Editorial Board
  • Disclosures: Creech reports no relevant financial disclosures.

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