AAP: CA-MRSA: What we know and what to do

October 14, 2008

Speaking to an overflow audience at this year’s AAP Conference, Robert Frenck, MD, a professor of infectious diseases (ID) at Cincinnati Children’s Hospital Medical Center, prefaced his talk on community-associated methicillin-resistant Staphylococcus aureus (CA- MRSA) management by saying, “we just don’t know the all answers yet.”

Speaking to an overflow audience at this year’s AAP Conference, Robert Frenck, MD, a professor of infectious diseases (ID) at Cincinnati Children’s Hospital Medical Center, prefaced his talk on community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) management by saying, “we just don’t know the all answers yet.”

Even after a decade since its emergence, CA-MRSA is still flummoxing ID experts,making treatment all the more complex for primary care physicians. “Oneof the things we now know is that CA-MRSA has a much lower prevalence in the noseas compared to common staph,” said Frenck. This puts into question the valueof nasal swabs for CA-MRSA testing. In terms of presentation, “90% of casespresent as skin wound infections-that’s the good thing,” notedFrenck.

Many pediatricians participating in the discussion inquired about what is the best protocol to deal with suspected cases of CA-MRSA. Frenck replied by saying that there is no one protocol yet, but “if there is pus present in the wound, you must drain it, and then culture,” said Frenck. The audience also inquired about the upcoming flu season. “For the flu season, if you have a patient that is not responding to antimicrobials for pneumonia, then you should think about CA-MRSA,” concluded Frenck.