Related Experiment Video
Updated: May 12, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
What is the rate of methicillin-resistant Staphylococcus aureus and Gram-negative infections in open fractures?
Antonia F Chen1, Verena M Schreiber, Wesley Washington
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Mercy Professional Office Building, 1350 Locust Street Suite 220, Pittsburgh, PA, 15219, USA.
Background:
There have been increasing reports of methicillin-resistant Staphylococcus aureus (MRSA) infections in the community, but it is unclear whether infectious organisms in open fracture infections have changed and if our current regimen of antibiotic prophylaxis is therefore obsolete.
Questions/Purposes:
We determined the recent incidence of MRSA and Gram-negative organism infections after open fractures.
Methods:
We performed a retrospective cohort study on 189 patients with 202 open fractures treated from 2009 to 2010. During the followup, patients were evaluated for signs of infection using the Centers for Disease Control and Prevention criteria. We determined the organisms using routine microbiology culture. The minimum followup was 3 months (median, 47 months; range, 3-108 months).
Results:
Of the 202 open fractures, 20 (10%) developed infections. The most common organism was Staphylococcus, whereas five (25%) of those infected were positive for MRSA, and 11 (55%) of those with infection were cultured for at least one Gram-negative organism. Six (30%) open fractures had infections that grew out multiple organisms. The incidence of MRSA infections in our open fracture population was 2.5%.
Conclusions:
There is a high incidence of MRSA and Gram-negative infections after open fractures, which may indicate that current antibiotic regimens need to be changed.
Level Of Evidence:
Level IV, retrospective case-series. See the Guidelines for Authors for a complete description of levels of evidence.
Insights
Recent open fracture infections show a high incidence of methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative organisms. Current antibiotic prophylaxis may need updating to address these evolving pathogens.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Public Health
Background:
- Increasing community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections raise concerns about evolving pathogens in open fracture cases.
- The current antibiotic prophylaxis regimens for open fractures may be outdated due to potential changes in causative organisms.
Purpose of the Study:
- To determine the recent incidence of MRSA and Gram-negative organism infections following open fractures.
- To assess the current landscape of microbial pathogens in open fracture infections.
Main Methods:
- A retrospective cohort study was conducted on 189 patients with 202 open fractures treated between 2009 and 2010.
- Infection surveillance utilized Centers for Disease Control and Prevention criteria, with organism identification through routine microbiology cultures.
- Follow-up duration ranged from 3 to 108 months, with a median of 47 months.
Main Results:
- A total of 20 infections (10%) occurred among the 202 open fractures.
- Staphylococcus was the most frequent organism; MRSA accounted for 25% of infections (2.5% incidence in the overall population).
- Gram-negative organisms were identified in 55% of infections, and 30% of fractures showed polymicrobial infections.
Conclusions:
- The study reveals a significant incidence of MRSA and Gram-negative infections in open fracture cases.
- Findings suggest that current antibiotic prophylaxis strategies may require revision to effectively combat prevalent pathogens.
Related Concept Videos
01:25Clinical Significance of Antibiotic Resistance
01:25Mechanism of Antibiotic Resistance in MRSA
01:29Staphylococcal Skin Infections
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...