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Clinical outcomes of osteomyelitis patients infected with methicillin-resistant Staphylococcus aureus USA-300 strains

P Peyrani1, M Allen, D Seligson

  • 1University of Louisville, Louisville, Kentucky 40202, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|April 25, 2012
PubMed

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) USA-300 is a common cause of osteomyelitis. Outcomes for MRSA USA-300 osteomyelitis are similar to other MRSA strains with current treatments.

Area of Science:

  • Infectious Diseases
  • Orthopedics
  • Microbiology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) USA-300 strains are increasingly implicated in community-acquired infections.
  • While recognized as a cause of osteomyelitis, data on MRSA USA-300 incidence and outcomes remain limited.

Purpose of the Study:

  • To investigate the incidence and clinical outcomes of osteomyelitis caused by MRSA USA-300 strains.
  • To compare outcomes between MRSA USA-300 and non-USA-300 osteomyelitis cases.

Main Methods:

  • Retrospective study of patients with MRSA osteomyelitis at two health systems (January 2007–March 2008).
  • Pulsed-field gel electrophoresis used for MRSA USA typing.
  • Clinical outcomes assessed at 12 months; statistical analyses included Chi-square, Fisher exact, and Mann-Whitney tests.

Main Results:

  • Of 50 MRSA osteomyelitis cases, 27 (54%) were caused by the USA-300 strain.
  • Clinical failure rates were 22% for MRSA USA-300 and 30% for non-USA-300 strains (P = .509).
  • No significant difference in outcomes was observed between MRSA USA-300 and non-USA-300 osteomyelitis.

Conclusions:

  • MRSA USA-300 is a significant pathogen in osteomyelitis cases.
  • Current surgical and medical management strategies yield comparable outcomes for MRSA USA-300 and non-USA-300 osteomyelitis.

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