{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:35:15Z","timestamp":1783571715437,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2017,2,9]],"date-time":"2017-02-09T00:00:00Z","timestamp":1486598400000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23AI113150"],"award-info":[{"award-number":["K23AI113150"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prior studies of pediatric musculoskeletal infection have suggested that methicillin-resistant Staphylococcus aureus (MRSA) infections result in worse outcomes compared with infections with methicillin-susceptible S aureus (MSSA) strains. Based on these results, clinical prediction algorithms have been developed to differentiate between MRSA and MSSA early in a patient\u2019s clinical course. This study compares hospital outcomes for pediatric patients with MRSA and MSSA musculoskeletal infection presenting to the emergency department at a large tertiary care children\u2019s hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective study identified pediatric patients with S aureus musculoskeletal infection over a 5-year period (2008\u20132013) by sequential review of all pediatric orthopedic consults. Relevant demographic information, laboratory values, and clinical outcomes were obtained from the electronic medical record.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 91 identified cases of S aureus pediatric musculoskeletal infection, there were 49 cases of MRSA infection (53%) and 42 cases of MSSA infection (47%). There were no significant differences between MRSA and MSSA infections in median hospital length of stay (4.8 vs 5.7 days, P = .50), febrile days (0.0 vs 1.5 days, P = .10), and antibiotic duration (28 vs 34 days, P = .18). Methicillin-resistant S aureus infections were more likely to require operative intervention than MSSA infection (85% vs 62%, P = .15). A logistic regression model based on C-reactive protein, temperature, white blood cell count, pulse, and respiratory rate at presentation demonstrated poor ability to differentiate between MRSA and MSSA infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results demonstrated no significant differences between MSSA and MRSA musculoskeletal infections for most hospital outcomes measured. However, MRSA infections required more operative interventions than MSSA infections. In addition, a predictive model based on severity markers obtained at presentation was unable to effectively differentiate between MRSA and MSSA infection. The clinical utility and capacity for early differentiation of MRSA and MSSA depends on virulence patterns that may vary temporally and geographically.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofx013","type":"journal-article","created":{"date-parts":[[2017,2,9]],"date-time":"2017-02-09T16:01:50Z","timestamp":1486656110000},"source":"Crossref","is-referenced-by-count":20,"title":["Similar Clinical Severity and Outcomes for Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Pediatric Musculoskeletal Infections"],"prefix":"10.1093","volume":"4","author":[{"given":"Thomas J.","family":"An","sequence":"first","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Benvenuti","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E.","family":"Mignemi","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Departments of Orthopaedics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Martus","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Departments of Orthopaedics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Wood","sequence":"additional","affiliation":[{"name":"Pediatrics, Nashville, Tennessee"},{"name":"Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac P.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee"},{"name":"Pediatrics, Nashville, Tennessee"},{"name":"Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan G.","family":"Schoenecker","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Departments of Orthopaedics"},{"name":"Pediatrics, Nashville, Tennessee"},{"name":"Vanderbilt University Medical Center, Departments of Pharmacology"},{"name":"Pathology, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,2,9]]},"reference":[{"key":"2020081005171483500_CIT0001","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/BPO.0b013e318186eb4b","article-title":"The impact of the current epidemiology of pediatric musculoskeletal infection on evaluation and treatment guidelines","volume":"28","author":"Gafur","year":"2008","journal-title":"J Pediatr Orthop"},{"key":"2020081005171483500_CIT0002","first-page":"1","article-title":"Community-acquired 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