Related Experiment Video
Updated: Jun 1, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Increasing incidence of iliopsoas abscesses with MRSA as a predominant pathogen
Carolyn D Alonso1, Sam Barclay, Xuguang Tao
1Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States. cdahlen1@jhmi.edu
Objectives:
Iliopsoas abscesses (IPAs) are rare infections involving purulence within the muscles of the iliopsoas compartment, seldom due to Methicillin-resistant Staphylococcus aureus (MRSA) historically. This study was designed to evaluate the clinical characteristics and outcomes of patients with IPAs.
Methods:
A retrospective analysis of the demographics, clinical presentation, microbiologic data and treatment modalities among patients with IPAs from 1993 to 2007 at The Johns Hopkins Hospital was performed.
Results:
Among 61 patients with IPAs, infection rates increased from 0.5 cases/10,000 admissions (1993-2004) to 6.5 cases/10,000 admissions (2005-2007) (P < 0.001). An adjacent infectious focus was identified in 80% of patients, from skeletal (48%), intra-abdominal (23%), vascular (5%), genitourinary (3%), and cutaneous sources (2%). During 2005-2007, MRSA became a predominant pathogen, accounting for 25% of all cases and 37% of cases with a definitive microbiologic diagnosis (P = 0.006). Patients with IPAs >2 cm were more likely to undergo drainage, with trends toward longer hospitalizations, longer antibiotic courses, and increased odds of securing a definitive microbiologic diagnosis.
Conclusions:
Since 2005, rates of IPA have dramatically increased, with MRSA now the leading cause of infection. Knowledge of common pathogens should guide antimicrobial therapy including empiric coverage for MRSA in institutions with similar populations, especially if culture data are not available.
Insights
Iliopsoas abscess (IPA) rates have surged since 2005, with Methicillin-resistant Staphylococcus aureus (MRSA) becoming the primary cause. This highlights the need for empiric MRSA coverage in treatment.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Epidemiology
Background:
- Iliopsoas abscesses (IPAs) are rare infections of the iliopsoas muscle compartment.
- Historically, Methicillin-resistant Staphylococcus aureus (MRSA) has been an uncommon cause of IPAs.
Purpose of the Study:
- To evaluate the clinical characteristics and outcomes of patients diagnosed with iliopsoas abscesses.
- To identify trends in IPA incidence and causative pathogens over time.
Main Methods:
- Retrospective analysis of patient data from 1993 to 2007 at The Johns Hopkins Hospital.
- Demographic, clinical, microbiologic, and treatment data were collected for 61 IPA patients.
Main Results:
- IPA incidence increased significantly from 0.5 to 6.5 cases per 10,000 admissions between 1993-2004 and 2005-2007.
- MRSA emerged as a predominant pathogen during 2005-2007, accounting for 25% of all cases.
- Larger abscesses (>2 cm) were associated with drainage, longer hospitalizations, and more extensive antibiotic courses.
Conclusions:
- IPA rates have dramatically increased since 2005, with MRSA now being the leading cause.
- Antimicrobial therapy should include empiric coverage for MRSA, particularly when culture data are delayed or unavailable.
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:25Mechanism of Antibiotic Resistance in MRSA
01:29Staphylococcal Skin Infections
01:26Brain Abscess l: Introduction
01:25Urinary Tract Infection II: Pathophysiology
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...