Pediatric musculoskeletal Staphylococcus aureus bacterial infections have been evolving over the past decade, with more children diagnosed with the more virulent, methicillin-resistant Staphylococcus aureus (MRSA) today than 10 years ago. The result is longer hospitals stays, more surgeries and other related complications.

The researchers studied pediatric patients with culture-positive Staphylococcus aureus, including MRSA and the less toxic methicillin-sensitive Staphylococcus aureus (MSSA), between January 2001 and June 2010, at a major urban children's hospital.

There were 148 cases of acute musculoskeletal Staphylococcus aureus infection, including 111 MSSA and 37 MRSA, with the proportion of MRSA cases jumping from 9 percent in 2001 to 29 percent (three-fold) in 2010.

The MRSA-infected patients had longer hospital stays (13 days vs. 8 days), multiple surgical procedures (38 percent vs. 15 percent), and higher levels of C-Reactive Protein, the body's acute immune response to injury and infection, (38 percent vs. 15 percent). Complications, including deep vein thrombosis, septic emboli and septic shock, recurrent infection, and/or avascular necrosis, or cell death, were more common in patients with MRSA than MSSA infections (22 percent vs. 6 percent).

"As MRSA infections rise, prompt recognition and aggressive treatment of MRSA musculoskeletal infections are critical to avoiding life-threatening complications, and improving patient outcomes," said lead study author Eric Sarkissian. "Our findings support prior concern about the increased virulence of MRSA compared to MSSA infections. Optimizing patient outcomes will require increased healthcare provider vigilance, early broad-spectrum antibiotic administration and aggressive surgical management."