Data from October 21, 1990, through December 31, 2000, and from January 1 through December 31, 2001, were collected during 2 previous studies.12,13 Data from January 1, 2002, through December 31, 2003, were retrospectively collected as part of this study and compared with data from 1990 through 2001. All S aureus isolates were identified by a computer-assisted search of culture results from January 1, 2002, through December 31, 2003. The medical records were reviewed for all patients with MRSA isolates. This included children evaluated as outpatients in the clinics and emergency department as well as children admitted to Driscoll Children’s Hospital, a 200-bed tertiary care pediatric teaching hospital in Corpus Christi, Tex. Patients came from 30 counties in South Texas and the catchment area, and referral patterns were unchanged during this 14-year study period. Data were collected on patient age and sex, inpatient or outpatient treatment, community-acquired or nosocomial infection, presence of risk factors for MRSA infection, types of infections, susceptibility patterns of isolates, antibiotic therapy, requirement of incision and drainage, and mortality. Methicillin-resistant S aureus isolates not associated with disease (acute or chronic infection) were obtained from the nares, considered to be colonization, and excluded. Methicillin-resistant S aureus isolates associated with disease were obtained by a variety of methods, including collection of spontaneously draining purulent fluid, incision and drainage, bronchoalveolar lavage, and bone aspiration. Duplicate MRSA isolates from the same patient were eliminated unless they represented new infections that were diagnosed and treated during outpatient visits or hospitalizations that were separated by at least 1 month. Methicillin-resistant S aureus isolates from patients with chronic infections or relapses were considered duplicates and excluded.