Methicillin-resistant Staphylococcus aureus at children's hospitals in the United States.

Although methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important pathogen in hospitalized adults in the United States, reports of MRSA in pediatric patients have been infrequent. To determine the frequency at which MRSA is isolated from children, we surveyed the directors of microbiology at all acute care children's hospitals in the United States, and 57 of 67 (85%) laboratory directors responded to a mailed questionnaire. Those not testing S. aureus for methicillin susceptibility were excluded from the analysis. Of 53 (57%) laboratory directors 30 reported that MRSA had been isolated from patients in their hospitals. Between 1973 and 1981 the proportion of hospitals isolating MRSA increased significantly; 1 of 53 hospitals reported MRSA in 1973 compared to 20 of 53 hospitals in 1981 (P less than 0.001). Large hospitals (greater than or equal to 200 beds) reported MRSA isolates more frequently than did small hospitals (less than 200 beds) (P = 0.007). No association was found between the isolation of MRSA and the presence of burn or intensive care units, residency training programs or rotation of residents to other hospitals. MRSA isolation varied by standard metropolitan statistical area and geographic region. These data show that the isolation of MRSA is increasing in frequency in pediatric patients and that the reporting of MRSA from children's hospitals varies by hospital size, standard metropolitan statistical area and region. Since MRSA causes significant morbidity and mortality, further studies are necessary to identify the risk factors for MRSA infections and to develop effective control measures.