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
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U2 - 10.3122/jabfm.2011.05.110073
DO - 10.3122/jabfm.2011.05.110073
M3 - Article
C2 - 21900437
AN - SCOPUS:80052874568
SN - 1557-2625
VL - 24
SP - 543
EP - 550
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
IS - 5
ER -