Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy

Vanessa R. Laibl, Jeanne S. Sheffield, Scott Roberts, Donald D. McIntire, Sylvia Trevino, George D. Wendel

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Objective: The objective of this study was to review the presentation and management of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) in pregnant women. Methods: This was a chart review of pregnant patients who were diagnosed with MRSA between January 1, 2000, and July 30, 2004. Data collected included demographic characteristics, clinical presentation, culture results, and pathogen susceptibilities. Patients' pregnancy outcomes were compared with the general obstetric population during the study period. Results: Fifty-seven charts were available for review. There were 2 cases in 2000, 4 in 2001, 11 in 2002, 23 in 2003, and 17 through July of 2004. Comorbid conditions included human immunodeficiency virus and acquired immunodeficiency syndrome (13%), asthma (11%), and diabetes (9%). Diagnostic culture was most commonly obtained in the second trimester (46%); however 18% of cases occurred in the postpartum period. Skin and soft tissue infections accounted for 96% of cases. The most common site for a lesion was the extremities (44%), followed by the buttocks (25%), and breast (mastitis) (23%). Fifty-eight percent of patients had recurrent episodes. Sixty-three percent of patients required inpatient treatment. All MRSA isolates were sensitive to trimethoprim-sulfamethoxazole, vancomycin, and rifampin. Other antibiotics to which the isolates were susceptible included gentamicin (98%) and levofloxacin (84%). In comparison with the general obstetric population, patients with MRSA were more likely to be multiparous and to have had a cesarean delivery. Conclusion: Community-acquired MRSA is an emerging problem in our obstetric population. Most commonly, it presents as a skin or soft tissue infection that involves multiple sites. Recurrent skin abscesses during pregnancy should raise prompt investigation for MRSA.

Original languageEnglish (US)
Pages (from-to)461-465
Number of pages5
JournalObstetrics and Gynecology
Volume106
Issue number3
StatePublished - Sep 2005

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Methicillin-Resistant Staphylococcus aureus
Pregnancy
Obstetrics
Soft Tissue Infections
Skin
Population
Levofloxacin
Buttocks
Mastitis
Sulfamethoxazole Drug Combination Trimethoprim
Second Pregnancy Trimester
Vancomycin
Pregnancy Outcome
Rifampin
Gentamicins
Abscess
Postpartum Period
Inpatients
Pregnant Women
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Clinical presentation of community-acquired methicillin-resistant Staphylococcus aureus in pregnancy. / Laibl, Vanessa R.; Sheffield, Jeanne S.; Roberts, Scott; McIntire, Donald D.; Trevino, Sylvia; Wendel, George D.

In: Obstetrics and Gynecology, Vol. 106, No. 3, 09.2005, p. 461-465.

Research output: Contribution to journalArticle

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