C-reactive protein can be used to guide the empiric antimicrobial therapy of acute osteomyelitis in children.

Abstract

This study was to identify some indicators that could be used to distinguish methicillin-resistant Staphylococcus aureus (MRSA) from methicillin-sensitive Staphylococcus aureus (MSSA) to more accurately guide empirical antibiotics. Data of 91 cases of acute osteomyelitis in children with Staphylococcus aureus infection (including 29 cases of MRSA and 62 cases of MSSA) from July 2017 to March 2024 were retrospectively analyzed. Age, sex, duration of onset, maximum body temperature at onset, and inflammatory indicators detected after admission were compared between the MRSA group and the MSSA group. According to the receiver operating characteristic (ROC) curve, the diagnostic efficiency of MRSA infection was evaluated. Logistic regression analysis was used to determine independent risk factors for MRSA infection. There were no significant differences in age, sex, duration of onset, maximum body temperature, white blood cell count, neutrophil count, and erythrocyte sedimentation rate between the MRSA group and the MSSA group (P > 0.05). The median C-reactive protein in the MRSA group and the MSSA group was 97.93 and 58.10 mg/L, respectively, with statistical significance (P < 0.05). The sensitivity, specificity, and area under the curve of C-reactive protein for detecting MRSA infection were 41.4, 90.3, and 0.646%, respectively. Logistic regression analysis showed that C-reactive protein greater than 116.46 mg/L (odds ratio = 6.588, 95% confidence interval: 2.149-20.197) was an independent risk factor for predicting MRSA infection (P < 0.05). C-reactive protein greater than 116.46 mg/L can independently predict the likelihood of MRSA infection, and it is recommended to empirically select anti-MRSA treatment for such children.