RESULTS:: A total of 58 patients with culture-positive osteomyelitis were identified from 2008 to 2010. Sixteen of the infections were caused by MRSA (overall 26%). The percentage of patients with MRSA osteomyelitis according to the number of risk factors were as follows: all 4 risk factors, 50% (1 out of 2 patients); 3 risk factors, 42% (5 out of 12 patients); 2 risk factors, 21% (4 out of 19 patients); 1 risk factor, 50% (6 out of 12 patients); and 0 risk factor, 0% (0 out of 13 patients).
CONCLUSIONS:: The previously reported clinical predictive algorithm had a relatively poor diagnostic performance in this independent patient population. Specifically, the percentages of MRSA were the same for 1 risk factor compared with 4 (50%). Differences in bacteria strain, host responses, and a variety of other confounding variables could be responsible for these differences. Specific genetic markers may be the best early test to identify MRSA infections in the future.
LEVEL OF EVIDENCE:: Level III-case-control series.

PMID: 23872806 [PubMed - as supplied by publisher]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23872806?dopt=Abstract