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Updated: Sep 22, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Paediatric Osteomyelitis and Septic Arthritis Pathogen Distribution and Antimicrobial Resistance in a Single Centre:
Tianjiu Zhang1, Song Yu1, Xin Lv2
1Department of Orthopaedics, the Affiliated Hospital of Guizhou Medical University, Guiyang 550000, China.
Insights
Staphylococcus aureus remains the primary cause of acute haematogenous osteoarticular infections in children. The rising prevalence of methicillin-resistant S. aureus (MRSA) necessitates adjustments in empirical antibiotic treatment strategies.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Acute haematogenous osteoarticular infection (AHOI) pathogens and drug resistance vary geographically and temporally.
- Understanding these trends is crucial for effective treatment.
Purpose of the Study:
- To identify the most effective antimicrobial treatments for culture-negative AHOI.
- To analyze trends in pathogens and drug resistance in pediatric AHOI.
Main Methods:
- Retrospective analysis of clinical data from children with culture-positive AHOI (2007-2021).
- Examination of pathogen distribution and Staphylococcus aureus drug resistance across different time periods, age groups, and infection types.
Main Results:
- Staphylococcus aureus was the most common pathogen in pediatric AHOI.
- The proportion of methicillin-resistant S. aureus (MRSA) among S. aureus isolates significantly increased over time, reaching 76% in 2017-2021.
- No significant correlation was found between S. aureus distribution and patient age or infection type.
Conclusions:
- Staphylococcus aureus continues to be the predominant pathogen in pediatric AHOI.
- The increasing trend of MRSA infections impacts the selection of initial empirical antimicrobial therapy.
- This highlights the need for updated treatment guidelines for AHOI.
Background:
The epidemiological characteristics of the common pathogens underlying acute haematogenous osteoarticular infection (AHOI) and their resistance to drugs have temporal and regional differences.
Aims:
To determine the antimicrobial treatment most effective for culture-negative AHOI patients and those without bacterial cultures.
Methods:
Retrospective analysis of clinical data of children with AHOI who were culture positive from January 2007 to December 2021. And the distribution of the main pathogens and the drug resistance Staphylococcus aureus were analysed in different time periods, age groups and infection types.
Results:
A total of 188 cases met the inclusion criteria, including 97 cases of acute haematogenous osteomyelitis (AHO), 75 cases of septic arthritis (SA) and 16 cases of AHO concomitant with SA. The commonest causative pathogen in local children was S. aureus of Gram-positive cocci, followed by Streptococcus, and occasionally Gram-negative bacilli. The distribution of S. aureus had no significant correlation with age or infection type. Staphylococcus aureus accounted for 81.82%, 90.91% and 96.15% of all pathogens, and methicillin-resistant S. aureus (MRSA) accounted for 24.22%, 53.33% and 76.00% of S. aureus in 2007-11, 2012-16 and 2017-21, respectively. The frequency of MRSA infection showed an increasing trend over time.
Conclusion:
Staphylococcus aureus is still the main pathogen of AHOI in local children. The proportion of MRSA in S. aureus has also increased over time to 76% in the last 5 years, and the increased proportion of MRSA can affect the choice of initial empirical medication.
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