Staphylococcus aureus osteomyelitis in Hawaii.
BACKGROUND
The clinical and laboratory findings and outcomes of methicillin-resistant (MRSA) and methicillin-susceptible (MSSA) Staphylococcus aureus osteomyelitis have not been studied in Hawaii.


METHODS
Retrospective inpatient chart reviews of 62 culture-proven osteomyelitis patients between 1996 and 2007 were performed.


RESULTS
Fifteen patients (24%) had MRSA infection, and 47 patients (76%) had MSSA infection. Length of stay, chronic health problems, total duration of fever, and length of treatment were not significantly different between MRSA- and MSSA-infected patients. The peak erythrocyte sedimentation rate and C-reactive protein values were higher among MRSA infected patients (P values: .009 and .003, respectively).The systemic complication rate was higher in MRSA-infected patients (P value: .018).


CONCLUSIONS
Differing from other pediatric staphylococcal infections in Hawaii, the majority of the patients had MSSA infection. Pacific Islander and Native Hawaiian ethnicities were affected disproportionately and had MRSA infection more frequently. MRSA-infected patients had frequent surgical procedures and systemic complications.
Erdem
Guliz
G
Department of Pediatrics, University of Hawaii, Honolulu, HI 96826, USA. guliz@hawaii.edu
Salazar
Raymond
R
Kimata
Chieko
C
Simasathien
Thitiwan
T
Len
Kyra A
KA
Bergert
Lora
L
Melish
Marian
M
D000293:Adolescent; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000382:microbiology*; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents