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Updated: May 26, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Community-acquired methicillin-resistant Staphylococcus aureus hand infections in the pediatric population
Michael Thomas Chung1, Patrick Wilson, Brian Rinker
1University of Kentucky College of Medicine, Lexington, KY, USA.
Purpose:
Recent studies have reported rates of methicillin-resistant Staphylococcus aureus (MRSA) hand infections in patients without risk factors ranging from 26% to 73%. The purpose of our study was to review a large series of pediatric hand infections to determine the rate of MRSA and identify potential risk factors.
Methods:
A retrospective review was performed on patients younger than 15 who were seen for hand infections (2001-2010). Patients were categorized according to medical problems, need for operation, abscess location, and mechanism of injury. Potential MRSA risk factors were assessed using a multivariate-regression model.
Results:
During the 10-year period, 415 patients were seen for hand infections. A total of 146 patients met the inclusion criteria: patients younger than 15 years of age who presented to the plastic surgery service requiring consultation for hand infections. The overall prevalence of MRSA-positive cultures was found to be 30%. The prevalence of MRSA was 29% in healthy patients and 0% in immunocompromised patients. The prevalence of MRSA increased in a linear fashion from patients without documentation of incision and drainage procedures to patients adequately treated with bedside incision and drainage to patients who required surgical drainage. There was a trend toward a higher prevalence of MRSA in deep space abscesses compared to other abscesses. Patients with a history of trauma and previous MRSA infections had a higher rate of MRSA than other patients.
Conclusions:
Traditionally, MRSA has been associated with hospitalization, intravenous drug use, recent antibiotic use, and compromised immunity. In our study, more severe, deep-space abscesses requiring surgical drainage and patients with a history of previous MRSA infections were found to have a higher prevalence of MRSA. The immunocompromised patients had no cases of MRSA and had higher incidences of less virulent bacterial infections. This suggests that acquisition of community-acquired MRSA skin and soft tissue infections in children and adolescents might not be associated with the traditional risk factors.
Type Of Study/Level Of Evidence:
Prognostic IV.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) hand infections were prevalent in 30% of pediatric patients. Severe abscesses and prior MRSA history were linked to higher rates, challenging traditional risk factors in children.
Area of Science:
- Pediatric infectious diseases
- Dermatology
- Plastic surgery
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) infections are a growing concern.
- Previous studies indicate a wide range (26-73%) of MRSA hand infections in patients lacking typical risk factors.
- Understanding MRSA prevalence and risk factors in pediatric populations is crucial.
Purpose of the Study:
- To determine the prevalence of MRSA in pediatric hand infections.
- To identify potential risk factors associated with MRSA in this demographic.
- To compare MRSA rates in healthy versus immunocompromised children.
Main Methods:
- Retrospective review of pediatric hand infections (2001-2010).
- Inclusion criteria: patients under 15 requiring plastic surgery consultation for hand infections.
- Multivariate-regression analysis to assess MRSA risk factors.
Main Results:
- Overall MRSA prevalence was 30% among 146 eligible pediatric patients.
- MRSA prevalence was 29% in healthy children and 0% in immunocompromised children.
- Higher MRSA rates correlated with deeper abscesses requiring surgical drainage and a history of prior MRSA infection.
Conclusions:
- Traditional MRSA risk factors (hospitalization, drug use, antibiotic use, immunocompromise) were not consistently associated with pediatric hand infections in this cohort.
- Deep-space abscesses and previous MRSA infections emerged as significant risk factors.
- Community-acquired MRSA in children may be acquired through different pathways than in adults.
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