Prevalence, severity, and treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) skin and soft tissue infections in 10 medical clinics in Texas: A South Texas Ambulatory Research Network (STARNet) study

Nicolas A. Forcade, Michael L. Parchman, James H. Jorgensen, Liem C. Du, Natalie R. Nyren, Lucina B. Treviño, Joel Peña, Michael W. Mann, Abilio Muñoz, Sylvia B. Treviño, Eric M. Mortensen, Brian L. Wickes, Brad H. Pollock, Christopher R. Frei

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives: Quantify the prevalence, measure the severity, and describe treatment patterns in patients who present to medical clinics in Texas with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI). Methods: Ten primary care clinics participated in this prospective, community-based study. Clinicians consented patients and collected clinical information, pictures, and wound swabs; data were processed centrally. MRSASelect™ was used for identification. Susceptibilities were determined via Etest® . Results: Overall, 73 of 119 (61%) patients presenting with SSTIs meeting eligibility requirements had CA-MRSA. Among these, 49% were male, 79% were Hispanic, and 30% had diabetes. Half (56%) of the lesions were ≥ 5 cm in diameter. Most patients had abscesses (82%) and many reported pain scores of ≥ 7 of 10 (67%). Many presented with erythema (85%) or drainage (56%). Most received incision and drainage plus an antibiotic (64%). Antibiotic monotherapy was frequently prescribed: trimethoprim- sulfamethoxazole (TMP-SMX) (78%), clindamycin (4%), doxycycline (2%), and mupirocin (2%). The rest received TMP-SMX in combination with other antibiotics. TMP-SMX was frequently administered as one double-strength tablet twice daily. Isolates were 93% susceptible to clindamycin and 100% susceptible to TMP-SMX, doxycycline, vancomycin, and linezolid. Conclusions: We report a predominance of CA-MRSA SSTIs, favorable antibiotic susceptibilities, and frequent use of TMP-SMX in primary care clinics.

Original languageEnglish (US)
Pages (from-to)543-550
Number of pages8
JournalJournal of the American Board of Family Medicine
Volume24
Issue number5
DOIs
StatePublished - Sep 2011

Fingerprint

Soft Tissue Infections
Sulfamethoxazole Drug Combination Trimethoprim
Methicillin-Resistant Staphylococcus aureus
Skin
Anti-Bacterial Agents
Research
Linezolid
Clindamycin
Doxycycline
Drainage
Primary Health Care
Disk Diffusion Antimicrobial Tests
Mupirocin
Therapeutics
Vancomycin
Erythema
Hispanic Americans
Abscess
Tablets
Pain

Keywords

  • Antibiotics
  • CA-MRSA
  • Epidemiology
  • Practice-based research
  • Soft tissue infections

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

Cite this

Prevalence, severity, and treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) skin and soft tissue infections in 10 medical clinics in Texas : A South Texas Ambulatory Research Network (STARNet) study. / Forcade, Nicolas A.; Parchman, Michael L.; Jorgensen, James H.; Du, Liem C.; Nyren, Natalie R.; Treviño, Lucina B.; Peña, Joel; Mann, Michael W.; Muñoz, Abilio; Treviño, Sylvia B.; Mortensen, Eric M.; Wickes, Brian L.; Pollock, Brad H.; Frei, Christopher R.

In: Journal of the American Board of Family Medicine, Vol. 24, No. 5, 09.2011, p. 543-550.

Research output: Contribution to journalArticle

Forcade, Nicolas A. ; Parchman, Michael L. ; Jorgensen, James H. ; Du, Liem C. ; Nyren, Natalie R. ; Treviño, Lucina B. ; Peña, Joel ; Mann, Michael W. ; Muñoz, Abilio ; Treviño, Sylvia B. ; Mortensen, Eric M. ; Wickes, Brian L. ; Pollock, Brad H. ; Frei, Christopher R. / Prevalence, severity, and treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) skin and soft tissue infections in 10 medical clinics in Texas : A South Texas Ambulatory Research Network (STARNet) study. In: Journal of the American Board of Family Medicine. 2011 ; Vol. 24, No. 5. pp. 543-550.
@article{ee6440e89ea04cf59decc1e67e1a5829,
title = "Prevalence, severity, and treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) skin and soft tissue infections in 10 medical clinics in Texas: A South Texas Ambulatory Research Network (STARNet) study",
abstract = "Objectives: Quantify the prevalence, measure the severity, and describe treatment patterns in patients who present to medical clinics in Texas with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI). Methods: Ten primary care clinics participated in this prospective, community-based study. Clinicians consented patients and collected clinical information, pictures, and wound swabs; data were processed centrally. MRSASelect™ was used for identification. Susceptibilities were determined via Etest{\circledR} . Results: Overall, 73 of 119 (61{\%}) patients presenting with SSTIs meeting eligibility requirements had CA-MRSA. Among these, 49{\%} were male, 79{\%} were Hispanic, and 30{\%} had diabetes. Half (56{\%}) of the lesions were ≥ 5 cm in diameter. Most patients had abscesses (82{\%}) and many reported pain scores of ≥ 7 of 10 (67{\%}). Many presented with erythema (85{\%}) or drainage (56{\%}). Most received incision and drainage plus an antibiotic (64{\%}). Antibiotic monotherapy was frequently prescribed: trimethoprim- sulfamethoxazole (TMP-SMX) (78{\%}), clindamycin (4{\%}), doxycycline (2{\%}), and mupirocin (2{\%}). The rest received TMP-SMX in combination with other antibiotics. TMP-SMX was frequently administered as one double-strength tablet twice daily. Isolates were 93{\%} susceptible to clindamycin and 100{\%} susceptible to TMP-SMX, doxycycline, vancomycin, and linezolid. Conclusions: We report a predominance of CA-MRSA SSTIs, favorable antibiotic susceptibilities, and frequent use of TMP-SMX in primary care clinics.",
keywords = "Antibiotics, CA-MRSA, Epidemiology, Practice-based research, Soft tissue infections",
author = "Forcade, {Nicolas A.} and Parchman, {Michael L.} and Jorgensen, {James H.} and Du, {Liem C.} and Nyren, {Natalie R.} and Trevi{\~n}o, {Lucina B.} and Joel Pe{\~n}a and Mann, {Michael W.} and Abilio Mu{\~n}oz and Trevi{\~n}o, {Sylvia B.} and Mortensen, {Eric M.} and Wickes, {Brian L.} and Pollock, {Brad H.} and Frei, {Christopher R.}",
year = "2011",
month = "9",
doi = "10.3122/jabfm.2011.05.110073",
language = "English (US)",
volume = "24",
pages = "543--550",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "5",

}

TY - JOUR

T1 - Prevalence, severity, and treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) skin and soft tissue infections in 10 medical clinics in Texas

T2 - A South Texas Ambulatory Research Network (STARNet) study

AU - Forcade, Nicolas A.

AU - Parchman, Michael L.

AU - Jorgensen, James H.

AU - Du, Liem C.

AU - Nyren, Natalie R.

AU - Treviño, Lucina B.

AU - Peña, Joel

AU - Mann, Michael W.

AU - Muñoz, Abilio

AU - Treviño, Sylvia B.

AU - Mortensen, Eric M.

AU - Wickes, Brian L.

AU - Pollock, Brad H.

AU - Frei, Christopher R.

PY - 2011/9

Y1 - 2011/9

N2 - Objectives: Quantify the prevalence, measure the severity, and describe treatment patterns in patients who present to medical clinics in Texas with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI). Methods: Ten primary care clinics participated in this prospective, community-based study. Clinicians consented patients and collected clinical information, pictures, and wound swabs; data were processed centrally. MRSASelect™ was used for identification. Susceptibilities were determined via Etest® . Results: Overall, 73 of 119 (61%) patients presenting with SSTIs meeting eligibility requirements had CA-MRSA. Among these, 49% were male, 79% were Hispanic, and 30% had diabetes. Half (56%) of the lesions were ≥ 5 cm in diameter. Most patients had abscesses (82%) and many reported pain scores of ≥ 7 of 10 (67%). Many presented with erythema (85%) or drainage (56%). Most received incision and drainage plus an antibiotic (64%). Antibiotic monotherapy was frequently prescribed: trimethoprim- sulfamethoxazole (TMP-SMX) (78%), clindamycin (4%), doxycycline (2%), and mupirocin (2%). The rest received TMP-SMX in combination with other antibiotics. TMP-SMX was frequently administered as one double-strength tablet twice daily. Isolates were 93% susceptible to clindamycin and 100% susceptible to TMP-SMX, doxycycline, vancomycin, and linezolid. Conclusions: We report a predominance of CA-MRSA SSTIs, favorable antibiotic susceptibilities, and frequent use of TMP-SMX in primary care clinics.

AB - Objectives: Quantify the prevalence, measure the severity, and describe treatment patterns in patients who present to medical clinics in Texas with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI). Methods: Ten primary care clinics participated in this prospective, community-based study. Clinicians consented patients and collected clinical information, pictures, and wound swabs; data were processed centrally. MRSASelect™ was used for identification. Susceptibilities were determined via Etest® . Results: Overall, 73 of 119 (61%) patients presenting with SSTIs meeting eligibility requirements had CA-MRSA. Among these, 49% were male, 79% were Hispanic, and 30% had diabetes. Half (56%) of the lesions were ≥ 5 cm in diameter. Most patients had abscesses (82%) and many reported pain scores of ≥ 7 of 10 (67%). Many presented with erythema (85%) or drainage (56%). Most received incision and drainage plus an antibiotic (64%). Antibiotic monotherapy was frequently prescribed: trimethoprim- sulfamethoxazole (TMP-SMX) (78%), clindamycin (4%), doxycycline (2%), and mupirocin (2%). The rest received TMP-SMX in combination with other antibiotics. TMP-SMX was frequently administered as one double-strength tablet twice daily. Isolates were 93% susceptible to clindamycin and 100% susceptible to TMP-SMX, doxycycline, vancomycin, and linezolid. Conclusions: We report a predominance of CA-MRSA SSTIs, favorable antibiotic susceptibilities, and frequent use of TMP-SMX in primary care clinics.

KW - Antibiotics

KW - CA-MRSA

KW - Epidemiology

KW - Practice-based research

KW - Soft tissue infections

UR - http://www.scopus.com/inward/record.url?scp=80052874568&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052874568&partnerID=8YFLogxK

U2 - 10.3122/jabfm.2011.05.110073

DO - 10.3122/jabfm.2011.05.110073

M3 - Article

C2 - 21900437

AN - SCOPUS:80052874568

VL - 24

SP - 543

EP - 550

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 5

ER -