Children at high risk as superbugs soar

Potentially lethal infections by hospital superbugs are soaring among children, scientists have warned.

Severe shortages of specialist nurses and infection-control staff are adding to rising rates of the bugs among babies and children, research indicates.

Youngsters on neonatal and paediatric wards are now among the highest risk groups for hospital- acquired infections.

The Independent revealed this week that 12 people have died and more than 300 others have been infected by an outbreak of a new strain of the diarrhoeal infection Clostridium difficile at Stoke Mandeville Hospital in Buckinghamshire.

C.difficile is linked to overuse of antibiotics and poor hygiene in hospitals, and cases of the potentially deadly infection have risen by 23 per cent in a year to more than 43,000 in 2004.

All the victims at Stoke Mandeville were over 65 and the infection mainly affects older people. But new evidence is emerging that rates of infections are rising among children.

A study of 96 hospitals by the Nosocomial Infection National Surveillance Service (NINSS) found that, between 1997 and 2002, there were 720 hospital infections among children.

While there was an average of 0.6 cases of infection per 1,000 patient days in hospital, paediatric intensive care units (ICUs) had a rate of 7.9, while neonatal ICUs had 4.2 and paediatric surgical wards 0.7. Only adult IC wards had a higher rate of infection than paediatric or neonatal ICUs.

Specialists are particularly worried about the increasing number of deadly superbugs such as methicillin-resistant Staphylococcus aureus (MRSA) among youngsters.

Researchers from the paediatric infectious disease unit at St George's Hospital in Tooting, south London, found that MRSA rates among children have risen almost twentyfold between 1990 and 2000.

S.aureus is a common infection, but the antibiotic-resistant strain, MRSA, is a form that can kill. The researchers found that MRSA cases among children under 15 in England and Wales rose from just four in 1990 to 77 in 2000. Babies under a year old accounted for 51 per cent of the cases.

The rise in the percentage of S.aureus cases that were antibiotic resistant rose from less than 1 per cent in 1990 to 15 per cent 10 years later.

Dr Mike Sharland, who led the study, said: "MRSA is now a serious problem in children in England and Wales. Active steps need to be taken to ensure that the problem will not escalate further in children to adult levels. "We recommend an urgent national review, identifying the risk factors for MRSA ... and the infection-control measures in place."

Commenting on the research, Dr Jim Gray, a microbiologist at Birmingham Children's Hospital, said the rise in MRSA cases presented a "considerable threat for the future". Rising antibiotic resistance among children could make treating even common infections increasingly difficult, he said.

Children under two are also among the high-risk group for C.difficile, particularly premature babies whose immune systems make it difficult for them to fight infection.

In babies, C.difficile can lead to the more serious and deadly condition of necrotising enterocolitis, which destroys the stomach tissues and has a death rate of up to 50 per cent among infants with a low birth weight.

Microbiologists have criticised the Government over the lack of official data on C.difficile rates among adults and children and have accused ministers of failing to take the problem seriously.

Yesterday, specialists also hit out at chronic nursing shortages in neonatal ICUs, which they said were adding to the problem of infection. Neil Marlow, a professor of neonatal medicine at the University of Nottingham, said: "At times, it can be an absolute nightmare. Most units are trying desperately to hit the recommendations that there should be one-on-one nursing for babies on full, high-dependency care, but there just aren't the staff.

"The Government says there has been extra money put in, but there has been no real improvement in services." His unit sometimes operates with up to 50 per cent of the nursing posts vacant, he said.

"It is a vicious circle. The posts are not filled, so the staff who work there are under more pressure, which means they are more likely to leave and the problem gets worse.

"We take infection control seriously, but of course it is more difficult without staff and resources."

Dr Jane Hawdon, a consultant neonatologist at University College Hospital in London, said: "Staff shortages in neonatal intensive care units are a problem up and down the country.

"It is a problem, but in a specialty, we have always given infection control a very high priority because the patients we deal with are very vulnerable."