A study, published in Clinical Infectious Diseases, examined the use of antibiotics among children with influenza and methicillin-resistant Staphylococcus aureus respiratory coinfection.
Researchers studied children, younger than 18 years, with the flu and acute respiratory failure across 34 pediatric intensive care units from November 2008 to May 2016. They compared baseline characteristics, clinical courses and therapies in children with:
• MRSA coinfection
• Non-MRSA bacterial coinfection
• No bacterial coinfection
Of the 170 children studies, 30 had influenza-MRSA pneumonia, 61 had non-MRSA bacterial coinfections and 71 had no bacterial coinfection.
The study showed influenza-MRSA was associated with more frequent leukopenia, acute lung injury, vasopressor use, extracorporeal life support and mortality compared to either non-MRSA group. The influenza-related mortality rate was 40 percent with MRSA compared to 4.3 percent without MRSA.
Of the children with influenza-MRSA coinfection receiving vancomycin within the first 24 hours of hospitalization, mortality was 12.5 percent if the treatment included a second anti-MRSA antibiotic. Vancomycin monotherapy in the first 24 hours correlated with a 69.2 percent mortality rate.