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Updated: Jun 10, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Community-acquired Staphylococcus aureus pneumonia among hospitalized children in Hawaii
Kyra A Len1, Lora Bergert, Shilpa Patel
1Department of Pediatrics, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96826, USA. kyra.len@kapiolani.org
Insights
Community-acquired Staphylococcus aureus pneumonia in Hawaiian children is often caused by MRSA, particularly in younger Pacific Islanders. MRSA infections led to more severe outcomes, including higher rates of intubation and death.
Area of Science:
- Pediatric Infectious Diseases
- Bacterial Pneumonia Research
- Antimicrobial Resistance Epidemiology
Background:
- Community-acquired Staphylococcus aureus (SA) pneumonia is endemic in Hawaiian children.
- Evaluating clinical and laboratory findings for both methicillin-resistant SA (MRSA) and methicillin-susceptible SA (MSSA) pneumonia is crucial.
Purpose of the Study:
- To assess the clinical characteristics, laboratory findings, and outcomes of pediatric pneumonia admissions caused by MRSA and MSSA in Hawaii.
- To identify demographic and clinical factors associated with MRSA versus MSSA pneumonia.
Main Methods:
- Retrospective chart review of 38 culture-proven SA pneumonia patients admitted to a pediatric tertiary medical center in Hawaii (1996-2007).
- Comparison of clinical data, laboratory findings, and patient outcomes between MRSA and MSSA pneumonia groups.
Main Results:
- MRSA accounted for 68% of SA pneumonia cases (26/38), with a younger mean age (2.8 years) compared to MSSA (6.7 years).
- Pacific Islander and Native Hawaiian children were disproportionately affected (P < 0.0001).
- MRSA patients had higher rates of intubation (75%), pleural effusions requiring chest tubes (72%), and mortality (2 deaths, both MRSA).
Conclusions:
- Younger Pacific Islander/Native Hawaiian children are disproportionately affected by MRSA pneumonia.
- MRSA-associated pneumonia presents with more severe disease, including increased need for intubation, chest tubes, and higher fatality rates.
- Both MRSA and MSSA pneumonia lead to prolonged hospitalizations, complications, and significant healthcare costs.
Summary Background:
Invasive community acquired (CA) Staphylococcus aureus (SA) disease has been endemically observed in Hawaiian children. We wanted to evaluate the clinical, laboratory findings, and outcomes of methicillin-resistant SA (MRSA) and methicillin-susceptible SA (MSSA) associated pneumonia admissions.
Methods:
We performed retrospective chart reviews of 38 culture proven SA pneumonia patients admitted to a pediatric tertiary medical center in Hawaii between January 1996 to December 2007.
Results:
Twenty-six patients (68%) had MRSA and 12 patients (32%) had MSSA infection. The mean age of MRSA patients was 2.8 and 6.7 years for MSSA patients (P < 0.05). Pacific Islander and Native Hawaiian patients were affected disproportionately compared to non-Pacific Islander and Hawaiian groups (P < 0.0001). Demographic data, days of fever, tachypnea, hypoxia, and length of stay (LOS) were not significantly different between MRSA and MSSA infected patients. The mean LOS was 26.2 days (range 6-138 days); mean length of fever was 12.4 days. Seventy five percent (15 of 20) of patients who required intubation had MRSA. Twenty-one of the 29 (72%) total patients with pleural effusions had MRSA infection and all required chest tube placements. Two (5%) patients died; both had MRSA infection.
Conclusions:
Younger Pacific Islander/Native Hawaiian children were affected disproportionately and had MRSA infection more frequently. MRSA infected patients appeared to have severe disease with frequent chest tube placement, intubation, and fatality. Overall, both MRSA and MSSA pneumonia resulted in prolonged hospitalization, multiple complications, and significant healthcare costs.
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