Work

Skin and soft-tissue infections caused by community-associated methicillin-resistant Staphylococccus aureus

Year: 2010

Type: article

Abstract: Background: Community-associated methicillin-resistant Staphylococccus aureus(CAMRSA) is an increasingly common cause of substantial morbidity worldwide. In several Latin American countries-including our own- the incidence of CA-MRSA infections has dramatically increased although it remains underdiagnosed in many cases. Skin and soft-tissue involvement are the most common, accounting for 85 to 95% of infections caused by this microorganism. The aim was to describe the epidemiological, clinical and prognostic features of skin and softtissue infections caused by CA-MRSA treated in general hospital. Methods: We included all patients with forunculosis and skin abscess by CA-MRSA treated in the infectology service between may of 2008 and september of 2009. CA-MRSA association was defined by epidemiological (community arousement) and microbiological features (oxacillin resistant isolates). The following variables of interest were analysed age, sex, risk factors, number of lesions, surgical drainage required, recurrence, presence of familiar forunculosis, empirical and post-isolation treatment, and CA-MRSA nasal carriers. Results: 23 patients were included. Men: 56%. Mean age: 32 years (3-69). Only one patient had classic risk factors (health care center worker). 52% (n = 12) had a sole lesion, while the others presented between 2 and 5. Only 6 cases required surgical drainage. Recurrence occurred in 21% (n = 5) and the majority, 74% (n = 17), had a history of familiar forunculosis. Empirical treatment had been given to 20 patients; being inadequate in 16 (80%) (first generation cephalosporin or amoxicillin plus clavulanic). Antibiotic treatment after isolation was: Trimethoprim/Sulfamethoxazole (n = 18), clindamycin (n = 4) y Vancomycin plus rifampicin (n = 1). Nasal sample was taken in 11 of 23, being positive only in 3 of them (27%). Conclusion: Patients with forunculosis CA-MRSA related were generally men of adult age and lacked risk factors. There was a large number of family outbreaks and nasal carriers were scarce, suggesting infection was due to interpersonal contact rather than state of carrier. Inadequate empirical treatment was very common. Comment: It is of paramount importante to bear in mind CA-MRSA as a posible cause of skin and soft-tissue infections in the community -even when risk factors are not present and particularly in a family outbreak- in order to start adequate empirical treatment and drain surgically if needed. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2010.02.469

Authors: W. Cornistein, M.I. Lespada, C. Rodriguez

Institution: Argerich Hospital

Language: English

Topic: Antimicrobial Resistance in Staphylococcus

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,900