title: Radiological findings of community-acquired methicillin-resistant and methicillin-susceptible Staphylococcus aureus pediatric pneumonia in Hawaii.
abstract: BACKGROUND
  Community-acquired Staphylococcus aureus (CA-SA) infections are common among pediatric patients in Hawaii.
  
  
  OBJECTIVE
  We wanted to characterize the radiological features of methicillin-susceptible (CA-MSSA) and methicillin-resistant (CA-MRSA) staphylococcal pneumonia in Hawaiian children.
  
  
  METHODS
  We retrospectively reviewed medical records and imaging studies of children with SA pneumonia identified from 1996 through 2007.
  
  
  RESULTS
  Of 40 children, 26 (65%) had CA-MRSA pneumonia and 14 patients (35%) had CA-MSSA pneumonia. CA-MRSA patients were significantly younger than CA-MSSA patients (65% younger than 1 year vs. 36% older). In a majority (62%) of CA-MRSA patients, the consolidation was unilateral; in most of the CA-MSSA cases (79%), the consolidation was bilateral. Fifty percent of the patients with CA-MRSA and 21% of those with CA-MSSA had pneumatoceles (P = 0.1). CA-MRSA patients more commonly had pleural effusions (85% vs. 64% for CA-MSSA) and pleural thickening (50% vs. 36% for CA-MSSA).
  
  
  CONCLUSIONS
  This case series describes the radiologic characteristics of CA-MRSA and CA-MSSA pneumonia in children in a highly endemic area. We found that CA-MRSA pneumonias are unilateral in a majority of pediatric pneumonia cases, are more common in children 1 year or younger, and have higher rates of complications in comparison to CA-MSSA patients.
authors.affiliation: Department of Pediatrics, University of Hawaii, John A. Burns School of Medicine, 1319 Punahou St., Room 755, Honolulu, HI 96826, USA. guliz@hawaii.edu
authors.forename: Guliz
authors.initials: G
authors.lastname: Erdem
authors.forename: Lora
authors.initials: L
authors.lastname: Bergert
authors.forename: Kyra
authors.initials: K
authors.lastname: Len
authors.forename: Marian
authors.initials: M
authors.lastname: Melish
authors.forename: Kevin
authors.initials: K
authors.lastname: Kon
authors.forename: Robert
authors.initials: R
authors.lastname: DiMauro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016106:Methicillin Resistance; D011023:Pneumonia, Staphylococcal / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology*; D015995:Prevalence; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000187:drug effects
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