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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
[Acute osteomyelitis caused by community-acquired methicillin-resistant Staphylococcus aureus in children: about 15
Mohamed Ben Jemaa1, Moez Trigui1, Wassim Zribi1
1Service de Chirurgie Orthopédique et Traumatologique, CHU Habib Bourguiba de Sfax, Sfax, Tunisie.
Abstract:
The treatment of acute osteomyelitis is becoming more challenging since the emergence of community-acquired methicillin-resistant Staphylococcus aureus. We collected data on all patients with acute osteomyelitis caused by this germ over a period of 21 years (January 1995-December 2016) and we analyzed the peculiarities of this disorder. Our case series includes 15 children, with an average age of 9 years. All patients had affected lower limb. Local trauma was reported in 8 cases and skin carriage in 4 cases. Acute onset was reported in 12 cases associated with pseudo-paralysis of the affected limb. One patient had Staphylococcus aureus pulmonary infection with signs of septicopyemia. Blood culture was positive in 8 cases. In one case PCR assay for detection of Panton-Valentine leukocidin was performed with positive result. All these patients underwent surgical debridement and received secondarily adapted empirical antibiotic therapy. Outcome was good in 8 cases and poor in the other cases, with transition to a chronic state in 6 cases and one case of death. Pathological fracture was reported in 3 cases. Osteomyelitis cause by community-acquired methicillin-resistant Staphylococcus aureus is associated with a pejorative outcome. Recognizing the clinical and paraclinical signs of these infections is essential for a specific and early therapeutic management.
Insights
Community-acquired methicillin-resistant Staphylococcus aureus osteomyelitis in children presents unique challenges, often leading to poor outcomes. Early recognition and tailored treatment are crucial for managing this severe bone infection.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Pediatric Medicine
Background:
- The rise of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) complicates acute osteomyelitis treatment.
- CA-MRSA infections present distinct clinical challenges compared to other strains.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of acute osteomyelitis caused by CA-MRSA in pediatric patients over a 21-year period.
- To identify key features associated with this specific type of bone infection.
Main Methods:
- A retrospective case series analysis of 15 children diagnosed with acute osteomyelitis due to CA-MRSA between January 1995 and December 2016.
- Data collection included patient demographics, clinical presentation, microbiological findings, treatment strategies, and patient outcomes.
Main Results:
- All 15 pediatric patients had lower limb infections, with 8 reporting local trauma and 4 skin carriage.
- Acute onset with pseudo-paralysis occurred in 12 cases; one patient had septicopyemia.
- Outcomes were poor in 7 cases, including chronic progression (6 cases) and one death; 3 cases experienced pathological fractures.
Conclusions:
- Acute osteomyelitis caused by CA-MRSA in children is associated with a high rate of poor outcomes and complications.
- Prompt recognition of clinical and paraclinical signs is essential for effective and early therapeutic intervention.
