Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008

David A. Talan; Anusha Krishnadasan; Rachel J. Gorwitz; Gregory E. Fosheim; Brandi Limbago; Valerie Albrecht; Gregory J. Moran; EMERGEncy ID Net Study Group

doi:10.1093/cid/cir308

Back

Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008

Journal article

Open access

Peer reviewed

Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008

David A. Talan, Anusha Krishnadasan, Rachel J. Gorwitz, Gregory E. Fosheim, Brandi Limbago, Valerie Albrecht, Gregory J. Moran and EMERGEncy ID Net Study Group

Clinical infectious diseases, Vol.53(2), pp.144-149

07/15/2011

DOI: 10.1093/cid/cir308

PMID: 21690621

Files and links (1)

url

https://doi.org/10.1093/cid/cir308View

Published (Version of record) Open Access

Abstract

Background. In the past decade, new methicillin-resistant Staphylococcus aureus (MRSA) strains have emerged as a predominant cause of community-associated skin and soft-tissue infections (SSTIs). Little information exists regarding trends in MRSA prevalence and molecular characteristics or regarding antimicrobial susceptibility profiles of S. aureus isolates. Methods. We enrolled adults with acute, purulent SSTIs presenting to a US network of 12 emergency departments during August 2008. Cultures and clinical information were collected. S. aureus isolates were characterized by antimicrobial susceptibility testing, pulsed-field gel electrophoresis, and toxin genes detection. The prevalence of S. aureus and MRSA and isolate genetic characteristics and susceptibilities were compared with those from a similar study conducted in August 2004. Results. The prevalence of MRSA was 59% among all SSTIs during both study periods; however, the prevalence by site varied less in 2008 (38%-84%), compared with 2004 (15%-74%). Pulsed-field type USA300 continued to account for almost all MRSA isolates (98%). Susceptibility to trimethoprim-sulfamethoxazole, clindamycin, and tetracycline among MRSA isolates remained greater than 90% in 2008. A higher proportion of MRSA infections were treated with an agent to which the infecting isolate was susceptible in vitro in 2008 (97%), compared with 2004 (57%). Conclusions. Similar to 2004, MRSA remained the most common identifiable cause of purulent SSTIs among patients presenting to a network of US emergency departments in 2008. The infecting MRSA isolates continued to be predominantly pulsed-field type USA300 and susceptible to recommended non-beta-lactam oral agents. Clinician prescribing practices have shifted from MRSA-inactive to MRSA-active empirical antimicrobial regimens.

Immunology

Infectious Diseases

Microbiology

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Comparison of Staphylococcus aureus From Skin and Soft-Tissue Infections in US Emergency Department Patients, 2004 and 2008
Creators: David A. Talan - Olive View-UCLA Medical Center
Anusha Krishnadasan - Olive View-UCLA Medical Center
Rachel J. Gorwitz - National Center for Emerging and Zoonotic Infectious Diseases
Gregory E. Fosheim - National Center for Emerging and Zoonotic Infectious Diseases
Brandi Limbago - National Center for Emerging and Zoonotic Infectious Diseases
Valerie Albrecht - National Center for Emerging and Zoonotic Infectious Diseases
Gregory J. Moran - Olive View-UCLA Medical Center
EMERGEncy ID Net Study Group
Resource Type: Journal article
Publication Details: Clinical infectious diseases, Vol.53(2), pp.144-149
DOI: 10.1093/cid/cir308
PMID: 21690621
NLM abbreviation: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
Publisher: Oxford Univ Press
Number of pages: 6
Grant note: Forest Pharmaceuticals
Language: English
Date published: 07/15/2011
Academic Unit: Emergency Medicine; Internal Medicine
Record Identifier: 9984297146402771

Metrics

25 Record Views

263 Times Cited - Web of Science