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

34 Scopus citations


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
Issue number5
StatePublished - Sep 1 2011



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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

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