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

Journal Name: 
The Journal of the American Board of Family Medicine
Authors: 
Forcade,Nicolas A.
Parchman,Michael L.
Jorgensen,James H.
Du,Liem C.
Nyren,Natalie R.
Trevino,Lucina B.
Pena,Joel
Mann,Michael W.
Munoz,Abilio
Trevino,Sylvia B.
Mortensen,Eric M.
Wickes,Brian L.
Pollock,Brad H.
Frei,Christopher R.
Abstract: 

ObjectivesQuantify 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). MethodsTen 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. MRSASelectTM was used for identification. Susceptibilities were determined via Etest(R). ResultsOverall, 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. ConclusionsWe report a predominance of CA-MRSA SSTIs, favorable antibiotic susceptibilities, and frequent use of TMP-SMX in primary care clinics

9
1
2011
Volume: 
24
Pages: 
543-550