High Prevalence of Methicillin-Resistant Staphylococcus aureus in Emergency Department Skin and Soft Tissue Infections
Abstract
Study objective We sought to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among emergency department (ED) patients with skin and soft tissue infections, identify demographic and clinical variables associated with MRSA, and characterize MRSA by antimicrobial susceptibility and genotype. Methods This was a prospective observational study involving a convenience sample of patients who presented with skin and soft tissue infections to a single urban public hospital ED in California. Nares and infection site cultures were obtained. A health and lifestyle questionnaire was administered, and predictor variables independently associated with MRSA were determined by multivariate logistic regression. All S aureus isolates underwent antibiotic susceptibility testing. Eighty-five MRSA isolates underwent genotyping by pulsed field gel electrophoresis, staphylococcal chromosomal cassette mec (SCC mec ) typing, and testing for Panton-Valentine leukocidin genes. Results Of 137 subjects, 18% were homeless, 28% injected illicit drugs, 63% presented with a deep or superficial abscess, and 26% required admission for the infection. MRSA was present in 51% of infection site cultures. Of 119 S aureus isolates (from infection site and nares), 89 (75%) were MRSA. Antimicrobial susceptibility among MRSA isolates was trimethoprim/sulfamethoxazole 100%, clindamycin 94%, tetracycline 86%, and levofloxacin 57%. Among predictor variables independently associated with MRSA…
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Many patients who have risk factors for hospital-associated MRSA will have a community-associated strain, based on microbiologic testing.
“However, other research has determined that many patients who have risk factors for hospital-associated MRSA, will have a community-associated strain, based on microbiologic testing. 8”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [8]
MRSA most frequently causes skin and soft tissue infection, such as cutaneous abscesses, furuncles and cellulitis.
“MRSA causes many infections, such as necrotizing fasciitis, 4 pneumonia, 5 meningitis 6 and endocarditis, 7 but most frequently it causes skin and soft tissue infection (SSTI), such as cutaneous abscesses, furuncles and cellulitis. 8”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [8]
A study in a San Francisco area ED isolated MRSA from 51% of 137 infection site cultures.
“A similar study conducted in a San Francisco area ED 8 isolated MRSA from 51% of 137 infection site cultures.”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [8]
Other studies have reported a strong association between MRSA and presence of an abscess, or furuncle or 'spider bite.'
“Other studies have reported a strong association between MRSA and presence of an abscess, or furuncle 8 or 'spider bite.' 14”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [8]
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- Authors
- Frazee, B. W., Lynn, J., Charlebois, E. D., Lambert, L., Lowery, D., & Perdreau-Remington, F.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Frazee, Bradley W.
- Venue
- Annals of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 45
- Issue
- 3
- Pages
- 311-320
- ISSN
- 0196-0644 (ISSN-L)
- OpenAlex
- W2148133809
- Cited by
- 494
- References
- 62
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 11 · 2023: 11 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 15 · 2018: 15 · 2017: 11 · 2016: 13 · 2015: 25 · 2014: 23 · 2013: 24 · 2012: 30
- FWCI
- 21.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Infectious Diseases › Dermatological diseases and infestations
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Keywords
- methicillin-resistant Staphylococcus aureus, skin and soft tissue infections, emergency department patients, community-acquired MRSA, antimicrobial susceptibility, Panton-Valentine leukocidin, furunculosis, risk factors, homeless patients, intravenous drug use, empirical antibiotic therapy, abscess
- MeSH terms
- Adolescent, Adult, California, Carrier State, Emergency Service, Hospital, Female, Furunculosis, Genotype, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Nose, Prospective Studies, Staphylococcal Infections, Staphylococcal Skin Infections, Staphylococcus aureus, Urban Health, Prevalence, Logistic Models, Odds Ratio, Methicillin Resistance, Community-Acquired Infections, Soft Tissue Infections
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