Evaluation of the Microbiology of Soft-Tissue Abscesses in the Era of Community-Associated Strains of Methicillin-ResistantStaphylococcus aureus: An Argument for Empirical Contact Precautions

2007 ◽  
Vol 28 (6) ◽  
pp. 730-732 ◽  
Author(s):  
Thomas R. Talbot ◽  
Joseph J. Nania ◽  
Patty W. Wright ◽  
Ian Jones ◽  
Dominik Aronsky
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Methicillin Resistant ◽  
Contact Precautions

To ascertain the microbiology of skin abscesses, emergency department records were reviewed to identify patients with debrided skin abscesses. Methicillin-resistantStaphylococcus aureuswas isolated from 255 (67.6%) of 377 culture samples from episodes in the adult cohort and from 145 (79.7%) of 182 culture samples from episodes in the pediatric cohort. Thus, empirical use of contact precautions for patients with skin abscesses should be strongly considered.

scholarly journals Just the Facts: Methicillin-resistant Staphylococcus aureus and soft tissue abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 149-151
Author(s):  
Heather Murray ◽  
Kirk Leifso
Keyword(s):  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incision And Drainage ◽  
Methicillin Resistant ◽  
Soft Tissue Abscess ◽  
Mrsa Strains ◽  
Almost All

Soft tissue abscess used to be an easy emergency department (ED) presentation: perform an incision and drainage (I + D) and discharge your patient. Times have changed. Methicillin-resistant Staphylococcus aureus (MRSA) is now a major cause of soft tissue abscess in ED patients. MRSA is, by definition, resistant to cloxacillin and cephalosporins. Almost all Canadian strains are susceptible to vancomycin and linezolid. MRSA strains are variably susceptible to trimethoprim-sulfamethoxazole (TMP-SMX), tetra/doxycycline, and clindamycin, with pooled Canadian clindamycin resistance just over 40%.

scholarly journals Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department

CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 430-438 ◽  
Author(s):  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Marc Romney ◽  
John Fahimi ◽  
Devin Harris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Methicillin Resistant ◽  
Period Prevalence ◽  
Monthly Period ◽  
Mrsa Infection

ABSTRACT Objective: We sought to estimate the period prevalence of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI) and evaluate risk factors for MRSA SSTI in an emergency department (ED) population. Methods: We carried out a cohort study with a nested case–control design. Patients presenting to our ED with a wound culture and a discharge diagnosis of SSTI between January 2003 and September 2004 were dichotomized as MRSA positive or negative. Fifty patients with MRSA SSTI matched by calendar time to 100 controls with MRSA-negative SSTI had risk factors assessed using multivariate conditional logistic regression. Results: Period prevalence of MRSA SSTI was 54.8% (95% confidence interval [CI] 50.2%–59.4%). The monthly period prevalence increased from 21% in January 2003 to 68% in September 2004 (p < 0.01). Risk factors for MRSA SSTI were injection drug use (IDU) (odds ratio [OR] 4.6, 95% CI 1.4–16.1), previous MRSA infection and colonization (OR 6.4, 95% CI 2.1–19.8), antibiotics in 8 weeks preceding index visit (OR 2.6, 95% CI 1.2–8.1), diabetes mellitus (OR 4.1, 95% CI 1.4–12.1), abscess (OR 5.6, 95% CI 1.8–17.1) and admission to hospital in previous 12 months (OR 2.6, 95% CI 1.1–11.2). Conclusion: The period prevalence of MRSA SSTI between January 2003 and September 2004 was 54.8% at our institution. There was a marked increase in the monthly period prevalence from the beginning to the end of the study. Risk factors are IDU, previous MRSA infection and colonization, prescriptions for antibiotics in previous 8 weeks and admission to hospital in the preceding 12 months. On the basis of local prevalence and risk factor patterns, emergency physicians should consider MRSA as a causative agent for SSTI.

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