Comparison of Staphylococcus aureus from skin and soft-tissue infections in US emergency department patients, 2004 and 2008
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-β-lactam oral agents. Clinician prescribing practices have shifted from MRSA-inactive to MRSA-active empirical antimicrobial regimens.
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S. aureus, in its methicillin sensitive and methicillin resistant form (MRSA), is a common opportunistic pathogen, responsible for the majority of all superficial skin infections, resulting in increased morbidity, mortality, and tremendous health-care costs.
“S. aureus, in its methicillin sensitive and methicillin resistant form (MRSA), is a common opportunistic pathogen, responsible for the majority of all superficial skin infections, resulting in increased morbidity, mortality, and tremendous health-care costs [20].”
From Interactions of Methicillin Resistant Staphylococcus aureus USA300 and Pseudomonas aeruginosa in Polymicrobial Wound Infection (2013) · cites this paper as [20]
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- Authors
- Talan, D. A., Krishnadasan, A., Gorwitz, R. J., Fosheim, G. E., Limbago, B., Albrecht, V., Moran, G. J., & for The EMERGEncy ID Net Study Group
- Affiliations
- University of California, Los Angeles (US)
- Centers for Disease Control and Prevention (US)
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-20
- Volume
- 53
- Issue
- 2
- Pages
- 144-149
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2027912106
- Cited by
- 300
- References
- 25
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 11 · 2023: 10 · 2022: 13 · 2021: 24 · 2020: 17 · 2019: 17 · 2018: 20 · 2017: 25 · 2016: 32 · 2015: 33 · 2014: 26 · 2013: 35 · 2012: 22
- FWCI
- 18.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (U01CK000176, U01CI000353)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Infectious Diseases › Otolaryngology and Infectious Diseases
- Keywords
- methicillin-resistant Staphylococcus aureus, community-acquired MRSA, skin and soft tissue infections, USA300, antimicrobial susceptibility, pulsed-field gel electrophoresis typing, toxin genes, emergency department patients
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Bacterial Toxins, Emergency Service, Hospital, Female, Genotype, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Staphylococcal Skin Infections, United States, Prevalence, Cluster Analysis, Electrophoresis, Gel, Pulsed-Field, Community-Acquired Infections, Soft Tissue Infections, Methicillin-Resistant Staphylococcus aureus, Young Adult, Molecular Typing
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