For the study, researchers culled the medical records of 290 children admitted to Children's Medical Center Dallas between January 1999 and December 2003 with acute osteomyelitis. The median age of those surveyed was six years. Sixty percent were male. Symptoms such as localized pain, fever, tenderness, swelling and limping were observed in more than half the patients.
The researchers divided the patient population into two groups to verify whether MRSA infections were becoming more common and more severe. They then compared patients with MRSA osteomyelitis to children with non-MRSA osteomyelitis, which included those with methicillin-sensitive S. aureus (MSSA) infections. They also reviewed outcomes, including duration of fever, the type and length of antibiotic therapy, and the frequency of complications, such as muscle inflammation, bone abscesses, disseminated disease and the need to drain the bone surgically.
“Though the clinical characteristics of the participants didn't change significantly between the first and second study periods, children who were treated in the latter period for osteomyelitis fared far worse, possibly because MRSA infections were more common”, said Dr. Octavio Ramilo, professor of pediatrics at UT Southwestern and senior author of a study.
For example, in the second study period, bone abscesses were observed in 69 percent of the patients with MRSA osteomyelitis versus 26 percent among those with MSSA infections. Children admitted with MRSA osteomyelitis during the second study period also spent an average of 42 days on antibiotics, almost two weeks longer than those diagnosed with MSSA.
Ramilo said the number of children who needed surgery was also striking. Seventy-eight percent of the patients with MRSA required surgery, compared with 49 percent of those with MSSA. He said the findings underscore the need for multicenter studies to identify the best antibiotic regimens as well as the best surgical approaches for complications.
MEDICA.de; Source: UT Southwestern Medical Center