Knowledge gaps and fear — some of it unjustified — are common among the caregivers of children with a drug-resistant staph bacterium known as MRSA, according to the results of a small study from the Johns Hopkins Children Center. These caregivers thirst for timely, detailed and simple information, the researchers add.
The study's findings, published online in The Journal of Pediatrics, underscore the need for healthcare staff to do a better job in educating parents, while also addressing concerns and allaying fears, the investigators say.
"What these results really tell us is not how little parents know about drug-resistant infections, but how much more we, the healthcare providers, should be doing to help them understand it," says senior investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Hopkins Children's.
Conducting bedside interviews with 100 parents and others caring for children hospitalized with new or established MRSA, or methicillin-resistant Staphylococcus aureus, the investigators found that nearly one-fifth (18 of the 100) had never heard of MRSA. Some of the children in the study were symptom-free carriers who were hospitalized for other reasons, while others had active MRSA infections. This increasingly common antibiotic-resistant bacterium causes skin and soft-tissue infections in healthy people, but can lead to invasive, sometimes fatal, infections in seriously sick patients and in those with weak immune systems.
To prevent the spread of MRSA to other patients, Hopkins Children's in 2007 began screening all children admitted to its intensive-care units. They are then screened weekly until discharge.
In the study, 29 of the 100 caregivers said they didn't know that their child had MRSA, but only nine of these cases involved newly identified cases, meaning that 20 children had been diagnosed with MRSA during past hospitalizations, yet parents and guardians were unaware. Investigators said the caregivers expressed frustration and confusion with the delayed revelation, a finding showing the importance of promptly communicating any and all new information to parents and doing so in plain language.
Among the 71 caregivers who knew of their child's MRSA diagnosis, 63(89 percent) revealed concerns, 55 (77 percent) worried about subsequent MRSA infections, and more than half (36) worried about their child spreading MRSA to others. Widespread uncertainty existed among them about whether to share the news with the child's school, primary-care pediatrician or home nurse. Some parents said they didn't understand the difference between having an active infection and being a carrier.
Eleven of the 71 (16 percent) caregivers said their child's MRSA diagnosis would lead to social stigma, fearing isolation both by friends and at school.
To help address these fears, physicians and nurses caring for children with MRSA should ask parents repeatedly if they have lingering concerns or questions, the researchers note. And they should take extra care to relieve worries among parents about future infections in the child or the fear of their child spreading MRSA to others. This can be done by putting the risks in perspective and by giving clear, specific risk-minimizing instructions tailored to each child's situation and health status, the researchers say.
Because children with MRSA do not pose a serious risk to healthy people outside of the hospital, restricting play time with friends and schoolmates is unjustified and doing so can be psychologically damaging to a child, the researchers say.
"An old axiom in pediatric medicine says that when you treat a child, you treat the whole family, so it is up to the physicians to ensure that the family understands what MRSA is and, more importantly, what it is not," Milstone noted.
"As physicians, we often focus too much on accurate diagnosis and effective treatment and not enough on helping patients and their families make sense of the diagnosis and what it means to them," says lead investigator Arnab Sengupta, M.B.B.S., M.P.H., formerly of Hopkins and now a pediatric resident at University of Illinois at Chicago.
Indeed, parents who received such guidance reported feeling less stressed and having fewer concerns about MRSA.
As the mother of one patient put it, "The best way to destigmatize MRSA is to inform the parent and the child what MRSA is and what their exact status is. That makes life easier."
The research was funded by the National Institutes of Health.
Other investigators in the study include Trish Perl, M.D. Ms.C., and Cynthia Rand, Ph.D., both of Hopkins.
Conflict-of-interest disclosure: Aaron Milstone and Trish Perl receive grant support from Sage Products, Inc. Perl is on the advisory board and has received honorarium from Pfizer and BioMerieux, and was on the advisory panel for Theradoc, Inc., manufacturer of infection surveillance systems. She has received honorarium from 3M, a manufacturer of drug-delivery and infection-prevention systems.
The terms of these arrangements are being managed by The Johns Hopkins University in accordance with its conflict-of-interest policies.
Related: Community-Acquired MRSA Becoming More Common in Pediatric ICU Patients http://www.hopkinschildrens.org/Community-Acquired-MRSA-Becoming-More-Common-in-Pediatric-ICU-Patients.aspx
In the Fight Against Life-Threatening Catheter Infections, Length of Use is Key http://www.hopkinschildrens.org/In-the-Fight-Against-Life-Threatening-Catheter-Infections-Length-of-Use-of-Key.aspx
Simple Steps Prevent Life-Threatening Bloodstream Infections in Children http://www.hopkinschildrens.org/Simple-Steps-Prevent-Life-Threatening-Bloodstream-Infections-in-Children.aspx
Ekaterina Pesheva | EurekAlert!
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.
Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...
Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.
They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...
A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...
For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.
In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...
Animal photoreceptors capture light with photopigments. Researchers from the University of Göttingen have now discovered that these photopigments fulfill an...
19.03.2018 | Event News
16.03.2018 | Event News
13.03.2018 | Event News
21.03.2018 | Physics and Astronomy
21.03.2018 | Materials Sciences
21.03.2018 | Life Sciences