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Updated: Mar 9, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Methicillin-Resistant Staphylococcus aureus Pneumonia in Critically Ill Trauma and Burn Patients: A Retrospective
Kristen L Bunnell1, Andrew R Zullo1,2, Christine Collins1
11 Department of Pharmacy, Rhode Island Hospital , Providence, Rhode Island.
Background:
The timing and risk factors for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in trauma patients are not well characterized. This information is critical for the selection of appropriate empiric antibiotics. The objective of this study was to determine the incidence of MRSA pneumonia in early-onset and late-onset pneumonia and to identify risk factors for MRSA in the trauma-burn intensive care unit (ICU).
Patients And Methods:
We conducted a retrospective cohort study from January 2012 to March 2015 of patients in the trauma and burn ICU with clinical and microbiologic evidence of pneumonia. Demographics, injury type and severity, co-morbidities, antimicrobial agents, and MRSA nasal colonization at ICU admission were extracted from the medical record. A multi-variable exact logistic regression was performed to assess predictors of MRSA pneumonia.
Results:
Eighty patients with 88 episodes of pneumonia were included in the cohort. Ten patients had MRSA pneumonia, an overall incidence of 11.4% of pneumonia episodes with a median onset of seven days. The proportion of MRSA pneumonia episodes was not significantly different in early-onset (<5 days) or late-onset pneumonia, and there were no statistically significant risk factors for developing MRSA pneumonia. The majority of patients with MRSA had at least one known risk factor including homelessness, substance abuse, and receipt of broad-spectrum antibiotic agents.
Conclusions:
The 11.4% overall incidence of MRSA pneumonia in this trauma-burn cohort was similar to what has been reported in other trauma populations, although MRSA was equally likely to be identified in early- and late-onset pneumonia. Our results suggest that risk factors other than duration of hospitalization may be important considerations in the decision to initiate MRSA-active empiric therapy for pneumonia in the trauma-burn ICU.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia occurred in 11.4% of trauma patients, with no difference between early or late onset. Risk factors beyond hospitalization duration may influence empiric antibiotic choices.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Trauma Surgery
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in trauma patients lacks characterization regarding timing and risk factors.
- Understanding these factors is crucial for selecting appropriate empiric antibiotics.
Purpose of the Study:
- To determine the incidence of MRSA pneumonia in early- and late-onset cases.
- To identify risk factors for MRSA pneumonia in a trauma-burn intensive care unit (ICU).
Main Methods:
- Retrospective cohort study of 80 patients with 88 pneumonia episodes in a trauma-burn ICU (2012-2015).
- Data collected included demographics, injury characteristics, comorbidities, and MRSA nasal colonization.
- Multivariable exact logistic regression analyzed predictors of MRSA pneumonia.
Main Results:
- Overall MRSA pneumonia incidence was 11.4%, with a median onset of seven days.
- No significant difference in MRSA pneumonia proportion between early- (<5 days) and late-onset pneumonia.
- No statistically significant risk factors identified; however, homelessness, substance abuse, and broad-spectrum antibiotics were common in MRSA cases.
Conclusions:
- The 11.4% incidence of MRSA pneumonia in trauma-burn patients aligns with other trauma populations.
- MRSA was equally prevalent in early- and late-onset pneumonia.
- Factors beyond hospitalization duration are important for guiding empiric MRSA-active therapy decisions in trauma-burn ICUs.
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