Related Experiment Video
Updated: Aug 17, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Community-associated methicillin-resistant Staphylococcus aureus in a pediatric emergency department in Newfoundland
Erin Peebles1, Robert Morris2, Roger Chafe2
1Department of Pediatrics, Children's Hospital, London Health Sciences Centre, London, Ontario;
Background:
First-generation cephalosporins and antistaphylococcal penicillins are typically the first choice for treating skin and soft tissue infections (SSTI), but are not effective for infections caused by methicillin-resistant Staphylococcus aureus (MRSA). It is currently unclear what percentage of SSTIs is caused by community-associated MRSA in different regions in Canada.
Objectives:
To determine the incidence of MRSA in children presenting to a pediatric emergency department with SSTI, and to determine which antibiotics were used to treat these infections.
Methods:
All visits to a pediatric emergency department were reviewed from April 15, 2010 to April 14, 2011. Diagnoses of cellulitis, abscess, impetigo, folliculitis and skin infection (not otherwise specified) were reviewed in detail to determine whether a culture was taken and which antibiotic was prescribed.
Results:
There were 367 cases of SSTI diagnosed over the study period. Forty-five (12.3%) patients had lesions that were swabbed for culture and sensitivity. S aureus was the most common organism found, with 14 (66%) methicillin-sensitive cases and seven (33%) methicillin-resistant cases. Of the seven cases of MRSA identified, only one patient had clear risk factors for hospital-acquired MRSA. First-generation cephalosporins were initially prescribed for 280 (76%) patients.
Conclusions:
The overall incidence of MRSA in the population presenting to a pediatric emergency department in Newfoundland and Labrador appeared to be low, although only a small percentage of infections were cultured. At this time, there appears to be no need to change empirical antibiotic coverage, which remains a first-generation cephalosporin.
Insights
The incidence of methicillin-resistant Staphylococcus aureus (MRSA) in pediatric skin infections in Newfoundland and Labrador was low. Current empirical antibiotic treatment with first-generation cephalosporins appears appropriate.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Epidemiology of Staphylococcus aureus
Background:
- First-generation cephalosporins and antistaphylococcal penicillins are standard for skin and soft tissue infections (SSTI).
- These antibiotics are ineffective against methicillin-resistant Staphylococcus aureus (MRSA).
- Regional MRSA prevalence in Canadian pediatric SSTIs is not well-established.
Purpose of the Study:
- To determine the incidence of MRSA in pediatric SSTIs.
- To identify antibiotics used for treating these infections.
- To assess the need for changes in empirical antibiotic therapy.
Main Methods:
- Retrospective review of pediatric emergency department visits from April 2010 to April 2011.
- Analysis of diagnoses including cellulitis, abscess, impetigo, and folliculitis.
- Detailed review of cultures and prescribed antibiotics for SSTIs.
Main Results:
- 367 SSTI cases were identified; 45 (12.3%) had cultures performed.
- Staphylococcus aureus was the most common pathogen (14 methicillin-sensitive, 7 methicillin-resistant).
- Only one MRSA case had clear hospital-acquired risk factors; first-generation cephalosporins were prescribed for 76% of patients.
Conclusions:
- MRSA incidence in pediatric SSTIs presenting to this emergency department was low.
- A small percentage of infections were cultured, limiting definitive conclusions.
- Current empirical antibiotic treatment with first-generation cephalosporins is considered appropriate.
Related Concept Videos
01:29Staphylococcal Skin Infections
01:25Mechanism of Antibiotic Resistance in MRSA
01:25Clinical Significance of Antibiotic Resistance