Most children treated for bone and joint infection do not have MRSA

The edition in brief

Four findings for paediatric practice. Across 15841 hospitalisations for acute haematogenous osteomyelitis or acute bacterial arthritis at 46 US children's hospitals between 2015 and 2024, only 17% of pathogen-coded cases were MRSA, yet 58% of children in whom no MRSA was found still received empiric MRSA cover. The disease-specific MRSA rate was consistently about half the hospital-wide rate (ratio 0.5, range 0.2 to 1.17), which means the antibiogram most units use to justify empiric vancomycin or clindamycin systematically overstates the risk for this infection. The American Academy of Pediatrics has published its 2026-2027 COVID-19 vaccination technical report, recommending vaccination for all infants aged 6 through 23 months, for moderately or severely immunocompromised children aged 6 months through 18 years, and for children aged 2 to 18 years in defined risk groups including those in congregate settings, never-vaccinated children, and those whose household contacts are at high risk. A tertiary NICU raised first-attempt neonatal intubation success from a baseline of 45% to a sustained 61% across 642 intubations by phasing in video laryngoscopy as the primary device and standardising oxygenation with nasal high flow; in infants under 1000 g success rose from 38% to 62%. A Cochrane review of 19 trials in 1554 preterm infants found the evidence on multisensory stimulation low to very low certainty, with no trial reporting neurodevelopmental disability at 18 to 24 months, no difference in death (RR 0.97, 95% CI 0.54 to 1.73), and a weight gain difference of 72.67 g whose clinical meaning is unclear. A Welsh audit of 168 infants found additional fractures on 7.1% of second skeletal surveys.