Ask Dr. Peltier
Should I be worried about my child getting antibiotic-resistant staph infections?
While antibiotic-resistant bacteria have been in the news lately, even causing some schools to close because of outbreaks, the concern has probably become greater than the risk.
Children definitely are at risk for Staphylococcus aureus (commonly known as staph) infections in general. Staph is a bacteria commonly found on the skin and in the nose. The germ travels by skin contact, from person to person or from one part of your body to another. It can enter the skin through a cut or an insect bite and cause an infection that usually appears as a pimple or boil.
Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of staph bacteria that is resistant to some of the more common antibiotics we use, including methicillin, penicillin and amoxicillin.
Only about 1 percent of the general population is colonized with MRSA, compared to about 30 percent with staph generally. That means they have the bacteria on their skin or in their nose, but aren't sick. But MRSA is getting more common. In the 1990s, most of these infections happened in hospitals. Today we see them increasing in occurrence outside of hospitals.Still, most MRSA infections are self-limited, localized infections that are treatable with such drugs as Bactrim™ or clindamycin. They develop into boils or abscesses that may need to be lanced or drained in order to completely heal.
The most common problem is recurrence, since children or entire families can become colonized with MRSA. It's rare to see the more serious types of infections – MRSA or otherwise – that we term "invasive." In these cases, bacteria seep into the bloodstream, lungs or bones, requiring hospitalization and intravenous antibiotics. Typically, unless a patient has some kind of immune system deficiency, invasive infections are rare.
We still have many drugs to treat MRSA. The concern is that bacteria could become resistant to those drugs, too. That's why pediatricians try to prescribe antibiotics only when necessary and use the least powerful drugs needed. Fortunately, some antibiotics, such as Bactrim™ now used to treat MRSA, have been found to be effective after years of limited use.
The most important step to prevent spread of MRSA is to wash your hands with soap and water or alcohol-based hand sanitizer, and teach children to do likewise. Keep wounds covered so they don't come in contact with other people. Don't share personal items such as towels, wash cloths and razors. And for anyone who knows they are colonized with MRSA, let your doctor know as soon as possible if any boils develop.
Christopher Peltier, MD, is a pediatrician with Pediatric Associates of Mount Carmel serving an editorial consultant for Young and Healthy. He also is assistant director of Community Pediatrics at Cincinnati Children's.
