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Updated: Jun 27, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Comparative severity of pediatric osteomyelitis attributable to methicillin-resistant versus methicillin-sensitive
John J Hawkshead1, Nimesh B Patel, Russell W Steele
1Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA. jhawkshe@tulane.edu
Background:
Staphylococcus aureus remains the most common etiology of hematogenous osteomyelitis in children. Recently emerged virulent strains of methicillin-resistant S. aureus (MRSA) strains now predominate. It remains uncertain whether these pathogens cause a measurably more severe illness than methicillin-sensitive strains.
Methods:
We reviewed records of 97 pediatric patients with hematogenous osteomyelitis of varying etiologies to determine whether there were significant differences among the groups in terms of predetermined measures of disease severity. These measures included degree and duration of elevated temperature, acute-phase reactants, length of hospitalization, the number of surgical procedures required, and long-term sequelae.
Results:
Differences in the clinical course of illness were observed. Patients with MRSA had a significant increase in degree and duration of elevated temperature (P = 0.0001 for both), acute-phase reactant measures (white blood cell count, P = 0.0001; C-reactive protein, P = 0.0058; erythrocyte sedimentation rate, P = 0.0046), initial length of hospital stay (P = 0.0001), and surgical interventions (all procedures, P = 0.0001; therapeutic procedures, only P = 0.0002) as compared with patients with osteomyelitis caused by other bacterial pathogens and culture-negative osteomyelitis. A similar general pattern was observed when the analysis was restricted to culture-positive staphylococcal cases only.
Conclusions:
Our results support the hypothesis that MRSA produces more severe bone infection and is likely to require more aggressive surgical and medical management.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) causes more severe pediatric osteomyelitis, leading to higher fevers, increased inflammation, longer hospital stays, and more surgeries compared to other bacterial causes.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Staphylococcus aureus is the leading cause of pediatric hematogenous osteomyelitis.
- Virulent strains of methicillin-resistant Staphylococcus aureus (MRSA) are increasingly prevalent.
- It is unclear if MRSA causes more severe illness than methicillin-sensitive strains.
Purpose of the Study:
- To compare the severity of pediatric hematogenous osteomyelitis caused by MRSA versus other pathogens.
- To evaluate differences in clinical outcomes based on bacterial etiology.
Main Methods:
- Retrospective review of 97 pediatric patients with hematogenous osteomyelitis.
- Comparison of disease severity measures including temperature, acute-phase reactants, hospitalization length, and surgical interventions.
Main Results:
- MRSA-infected patients showed significantly higher fevers and prolonged elevated temperatures.
- Increased acute-phase reactants (WBC, CRP, ESR) were observed in MRSA cases.
- MRSA was associated with longer hospital stays and a greater need for surgical procedures.
Conclusions:
- MRSA infections result in more severe pediatric osteomyelitis.
- MRSA-related osteomyelitis necessitates more aggressive medical and surgical management.
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