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Methicillin Resistant Staphylococcus Aureus Infection in Children
What is methicillin resistant Staphylococcus aureus?
- Methicillin resistant Staphylococcus aureus (MRSA) is a type of germ called bacteria. MRSA bacteria can cause infections in your child's body. Antibiotic medicines are used to kill germs. When the germ called Staphylococcus aureus (Staph) becomes resistant to (not killed by) certain antibiotic medicines, it is called MRSA. The Staph germ is commonly found on the skin and in the nose. Your child may carry the Staph germ but not get infected or sick. A carrier of MRSA can give it to other people and make them sick.
- An MRSA infection is very contagious. This means that it spreads easily from person to person. Anyone can get an MRSA infection. Your child can catch MRSA inside or outside of a hospital. MRSA may cause a mild, severe (very bad), or deadly infection in your child's body. The infection may be in your child's skin, blood, lungs, heart, or brain.
What increases my child's risk of getting an MRSA infection?
- Using antibiotics: If you do not follow your child's caregiver's instructions for giving antibiotics, it can cause germs to become resistant. Giving your child antibiotic medicine often or for a long time may cause resistance. If you give your child antibiotics when he does not need them, this can also cause resistance. When certain germs cannot be killed by medicine, your child may get an MRSA infection.
- Staying in the hospital: This includes having surgery, being in the ICU (intensive care unit), or being on a ventilator (breathing support machine). A long hospital stay, or sharing a room with someone who has an MRSA infection increases your child's risk of getting MRSA.
- Having tubes, lines or metal implants in your body: Medical tubes placed into your child's body increase his risk of getting an MRSA infection. These tubes may include intravenous (IV) tubes, and large tubes called central venous lines. A central venous line may be used if your child needs to have dialysis or other treatments. Other tubes that increase your child's risk of getting MRSA include feeding tubes, and catheters. A urinary catheter is a tube that is used to drain urine. MRSA may also live on and around metal implants, such as prosthetics (man-made body parts).
- Having a weak immune system: MRSA is more likely to cause an infection if your child has a weak immune system. The immune system is the part of the body that fights infection. Having diabetes (high blood sugar) may weaken your child's immune system. If your child has recently had chemotherapy (medicine to kill cancer), he may have a weak immune system.
- Having the flu or chicken pox: If your child is sick with influenza (the flu) or varicella (chicken pox), he may also get MRSA. This may make your child very sick.
- Spreading MRSA to babies: If you are a woman who has MRSA, you may give it to your baby when you give birth to him. Talk to your caregiver if you are a woman who has MRSA, and you want to breast-feed your baby.
What else increases my child's risk of getting an MRSA infection?
- Not keeping clean: This includes your child not washing his hands well (using soap and water), or long enough. Diaper changing and wiping runny noses also increase the risk of spreading MRSA from one person to another.
- Having a family member with an MRSA infection: If someone living in your home has an MRSA infection, your child is at a higher risk of catching it.
- Sharing personal items: MRSA may spread when items such as toys, clothing, bedding, washcloths, and bars of soap are shared.
- Sharing space with other children: Children in day care facilities are at a higher risk of getting MRSA.
- Playing on a sports team: Your child can catch MRSA during sports. This can happen with body contact (touching) or sharing equipment. In some sports, such as football, the skin may be scratched during play. This makes an opening for germs to enter the body.
- Abusing intravenous drugs: Older children may get MRSA infections if they use intravenous (IV) illegal (street) drugs.
What problems can an MRSA infection cause?
MRSA can cause serious and sometimes deadly infections. Ask your child's caregiver for more information about any of these infections:
- Skin, soft tissue, or wound infections: These infections may be small, or they may be very bad infections of the skin, muscles, and other soft tissue areas. This can include an infection of your baby's umbilical cord stump. The umbilical cord connects a baby to the baby's mother before the baby is born. Your child may also get infections in wounds caused by an injury, illness, or a cut made during surgery.
- Urinary tract infections: A urinary tract infection (UTI) is an infection of the kidneys, ureters or bladder. These organs make and store urine in your child's body.
- Osteomyelitis or arthritis: Osteomyelitis is an infection in your child's bone. Arthritis is a disease where your child's joints swell. Joints are the places in the body where two bones meet, such as your child's knees and elbows. Having MRSA and osteomyelitis may increase the risk of your child getting blood clots. If this happens, your child may have redness, pain, and swelling where the clot is. A blood clot in your child's lungs causes chest pain and trouble breathing.
- Infection of abdominal organs: The organs in your child's abdomen, such as your child's liver and spleen, may get infected.
- Meningitis: Meningitis is swelling of the coverings of your child's brain and spine.
- Pneumonia: Pneumonia occurs when there is an infection and swelling in your child's lungs.
- Bacteremia: Bacteremia occurs when MRSA germs enter your child's blood stream, and cause a blood infection.
- Infective endocarditis: Endocarditis is when there is inflammation (swelling) and infection of the inner lining of your child's heart.
What are the signs and symptoms of an MRSA infection?
Your child's signs and symptoms depend on what area of his body has an infection. They can include:
- Fever: This is a high body temperature.
- Infected skin: Your child may have an area of skin that is red and swollen, and feels warm and painful. He may have a dark spot on his skin that looks like a spider bite. Your child may have boils, dead skin, or pus on or under his skin. Skin sores can happen anywhere on your child's body. In babies who wear diapers, the sores are more likely to show up in the diapered area.
- Joint effusion: Fluid may build up in one of your child's joints, causing swelling, pain, and stiffness.
- Cough: Your child may have a cough. He may cough up blood.
- Breathing problems: Your child may find it hard to breathe.
How is an MRSA infection diagnosed?
Your child's caregiver will check your child's body. He may ask you if your child has been around anyone who has MRSA. Your child will need blood tests, and one or more of the following:
- Cultures: Your child's caregiver may take samples of sputum (mucus) from your child's throat or nose. He may take samples of pus from a wound. These fluids are sent to the lab and checked for MRSA.
- Biopsy: A biopsy may be done by taking a sample of your child's skin or other tissue that is infected. This tissue will be sent to the lab and tested for MRSA.
- Chest x-ray: This is a picture of your child's lungs and heart. Caregivers may use the x-ray to look for signs of infection (such as pneumonia), or a collapsed lung.
- Computed tomography scan: This is also called a CT scan. This is an x-ray that takes pictures of body areas. It can show places where your child's infection may have spread.
- MRI: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your child's body.
- Echo: This test is also called echocardiogram. Sound waves are used to show pictures of the size and shape of your child's heart. An echo can tell how well the heart pumps and how well blood flows through it. It may show signs of infection, such as fluid around the heart.
- Bone scan: Your child's caregiver may use this test to see if an infection has spread to your child's bones.
How is an MRSA infection treated?
Your child's treatment will depend on where the infection is in his body. With treatment, signs and symptoms such as a fever, cough, and pain may decrease, and wounds may heal. Your child's treatment may include any of the following:
- Antibiotics: This is germ-killing medicine that is used to treat MRSA. Your child may need to use more than one antibiotic medicine at a time.
- Blood thinners: These are medicines that can help break up blood clots and prevent them from forming.
- Isolation: If your child is in the hospital, caregivers and visitors will wear a gown and gloves when in his room. Caregivers and others who enter your child's room may also wear a mask. Supplies that are in his room will not be shared with other patients. This is done to prevent spreading his infection to other people. Visitors must also wash their hands before leaving to keep from spreading germs.
- Surgery: Your child may need surgery to remove MRSA-infected skin or bone. If your child has had surgery where man-made implants were placed in his body, these may need to be removed.
- Incision and drainage: If your child has an MRSA skin infection, caregivers may cut into the infected area of his skin. Doing this will help drain out the fluid (pus) that has collected in the area.
What are the risks of being treated for an MRSA infection?
- Antibiotic medicines used to treat your child's MRSA infection may cause a rash, nausea, vomiting (throwing up), and diarrhea. They may damage his kidneys, nerves, or eyes. He may feel muscle pain or weakness. His teeth may be stained, and his skin may become sensitive to light. Your child may have an irregular heart beat. His tongue may swell, and he may have trouble speaking. Antibiotic medicines may not work well with other medicines that he is taking. Blood thinning medicine makes it easy for your child to start bleeding, even without having a injury. Some antibiotic medicines may cause seizures or very bad problems that can be life-threatening.
- If your child's MRSA infection is not treated, it can get worse. The infection may spread to his skin, joints, kidneys, lungs, liver, spleen, bones, brain, and heart. If your child gets an infection in his spine, this could get worse and cause him to lose the use of his legs. Your child may get blood clots in his lungs and other body areas. These problems can be life-threatening. Talk to your child's caregiver if you have questions or concerns about your child's MRSA infection or treatment.
What can I do to help prevent my child from getting or spreading MRSA?
- Give antibiotics according to instructions: Always give your child's antibiotics exactly as ordered by his caregiver. Make sure your child finishes all of the medicine as prescribed, even if he feels better. Not doing this may cause the germ to become harder to kill. Never give prescription medicine without a caregiver's order. Never save antibiotics or give leftover antibiotics that were given to your child for another illness.
- Wash your hands and your child's hands: Tell everyone in your house to wash their hands with germ-killing soap and water after going to the bathroom. Wash your hands after changing diapers and before preparing or eating food. All family members must wash their hands after coughing and sneezing, and whenever they are dirty. After visiting a person who has MRSA, everyone must wash their hands. Keep you and your child's fingernails clean and cut short.
- Bathe often: Have your child bathe regularly with soap and water. Have him do this especially after sports such as football and wrestling, where there is physical contact with others. Children who use exercise equipment that is also used by others must bathe often.
- Wash all of your child's clothing: Wash all clothing with soap and water after it is worn by someone who may have, or has, an MRSA infection. Have your child change his underwear and sleep wear every day.
- Keep wounds covered: Keep any wounds that your child has clean and covered with a bandage until they are healed. Follow your child's caregiver's instructions for keeping the wound clean and covered. Do not let your child do activities with others until his sores have healed. Do not take younger children to day care facilities until all sores have healed.
- Do not share personal items: Do not let your child share food, drinks, forks, knives, spoons, plates, or cups with others. Do not let him share bars of soap or towels, and do not let children share toys. Do not give different babies the same pacifier.
- Clean surfaces well: Use alcohol or chlorine-based, germ-killing cleaner when cleaning surfaces such as tables, which are shared and touched often. Keep doorknobs, faucet handles, and the floor clean. Toys that children play with need to be cleaned well.
- Get rid of the germ: If someone in your home has an MRSA infection, your child and other family members are at a greater risk of getting it. You and your family may need to use antibiotic cream in the nose, or special soap when washing.
- Play safely: Make sure that your child uses proper safety gear and clothing when playing sports. This may prevent cuts or other injuries, and protect his skin from other children's germs.
Where can I find support and more information?
Having an MRSA infection may be life-changing for your child and your family. You, and your child may feel angry, sad, or frightened. These feelings are normal. Your child should speak to his caregivers, family, or friends about his feelings. Contact the following:
- Centers for Disease Control and Preventions
1600 Clifton Rd.
Atlanta , GA 30333
Phone: 1- 800 - 232-4636
Web Address: http://www.cdc.gov
- National Institute of Allergy and Infectious Diseases
NIAID Office of Communications & Government Relations
5601 Fishers Lane, MSC 9806
Bethesda, MD 20892-9806
For deliveries, use Rockville, MD 20852
Phone: 1- 301 - 496-5717
Phone: 1- 866 - 284-4107
Web Address: www3.niaid.nih.gov
When should I call my child's caregiver?
Call your child's caregiver if he has:
- A fever (high body temperature).
- A rash that is itchy, or spreading over his body.
- Skin areas that are red, swollen and feel warm. These areas also may be painful.
- A wound or area of pus under his skin that is not going away.
- Nausea (feeling sick to his stomach), vomiting (throwing up), or diarrhea.
- Muscle pain or weakness.
- Blood in his urine or bowel movement.
When should I seek immediate help?
Seek care immediately or call 911 if:
- Your child is coughing up blood.
- Your child suddenly has trouble speaking.
- Your child is having new trouble breathing.
- Your child has a fast heart beat and feels weak or dizzy.
- Your child's pain becomes very strong.
- Your child's tongue is swelling up.
- Your child has a seizure (convulsion).
- Your child has a headache with a stiff neck, and is very tired or confused.
- Your child has heavy bleeding.
You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.
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