Increasingly, children are hospitalized with MRSA colonization or infections.[1
] In an attempt to prevent MRSA transmission, some institutions screen patients to identify those colonized with MRSA.[10
] As a result, more caregivers are informed that their child has MRSA. To our knowledge, no studies have examined how effectively this information is conveyed to families and the impact it has on children and their caregivers. Our findings suggest that many caregivers whose hospitalized children were kept in contact isolation had no knowledge of MRSA and were unaware that their child had MRSA. Among those aware of their child's MRSA status, many were concerned, anxious, and wanting more information about MRSA in order to protect their child and family members.
In this study, we did not try to quantify caregiver's knowledge of MRSA; rather we assessed caregiver's perception of their knowledge of MRSA. Many caregivers felt that their knowledge was lacking and this perception often fueled concern and anxiety. These findings are similar to studies of perceptions of adult patients with MRSA.[12
] Caregivers who perceived a better understanding of MRSA were less concerned and anxious. Caregivers were eager for information beyond their child's MRSA status and the need for contact isolation. They wanted to learn how to protect their children and others in the household from MRSA infections. When a child is identified as being infected or colonized with MRSA, caregivers should be notified and the disclosure of information needs to be timely, personal, and comprehensive, yet individualized to the patient's context, recognizing unique risks to the child and other family members.
Most previous studies on patient perceptions regarding MRSA have involved adults.[12
] When counseling adult patients about MRSA, healthcare providers can reference data from relevant studies on the duration of MRSA colonization, long-term risk of MRSA infection, and intervention strategies to prevent MRSA infection.[14
] Similar studies are needed among children, so caregivers can be counseled and reassured with data from pediatric studies instead of extrapolation from adult literature and speculation.[18
Our study consistently identified caregivers who recognized a stigma from MRSA that affected the lives of their children and their families. This stigma extended to interactions in the hospital, at home, at school, and with other healthcare providers. Similar to patients with leprosy, human immunodeficiency virus (HIV) and sexually transmitted diseases, caregivers often did not share their child's MRSA status with others in fear of social isolation. [7
] Healthcare providers should be aware of the potential for a feeling of stigma when counseling families. Media descriptions of MRSA are often sensationalized and focus on contagiousness, severe disease and death. Community education campaigns and other strategies may help to allay unnecessary fears that provokes stigma surrounding MRSA.[20
Certain limitations should be considered when interpreting our data. Caregivers were mostly Caucasian or African American race, limiting the conclusions generalizability to other populations in the United States. Whether or not caregivers present at their child's bedside represent a group that is more or less likely to be concerned or worried about their child's care is unknown. Many of the important findings in our study emerged from qualitative data analysis. These findings may not be representative or quantifiable, but we provided the frequency of key themes wherever possible. Recognizing limitations of qualitative studies, we also accounted for our analytic process and included context for each quote, so that readers can assess our interpretations. To ensure reliability, two researchers independently evaluated the data to reach consensus.