Update on the characterization of Staphylococcus aureus skin infections in a pediatric dermatology tertiary health care outpatient facility: Antibiotic susceptibility patterns and decreased methicillin resistance

Diamantis, Melissa L.; Ortega‐Loayza, Alex G.; Morrell, Dean S.

doi:10.1016/j.jaad.2010.06.057

Cited by 8 publications

(9 citation statements)

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“…It has been suggested that, if the emergence of MRSA follows the same trend as beta-lactamase-positive S. aureus, the percentage of community-associated S. aureus infections caused by MRSA strains may approach 100% (6). However, this study, along with several other recent studies (9,18), indicates a possible interruption in that trend. Culture and susceptibility testing remain important, because in general, beta-lactam antibiotics are still considered the first line in staphylococcal infections that are susceptible, and knowledge of local resistance patterns of S. aureus can help guide empirical therapy.…”

Section: Discussionmentioning

confidence: 50%

“…However, there are indications that MRSA may be on the decline. A recent U.S. study found that the incidence of health care-associated invasive MRSA declined from 2005 to 2008 (18), and an analysis of S. aureus isolates from outpatient pediatric patients with SSTIs found the percentage of isolates that were MRSA was lower in 2008 and 2009 than in 2005 to 2007 (9).…”

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Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization

2012

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Infections due to Staphylococcus aureus present a substantial health problem in the United States (20, 23). S. aureus is a major cause of hospital-acquired pneumonia and lower respiratory tract infections (37) and the primary cause of surgical-site infections (36) and skin and soft tissue infections (SSTIs) (29) and is now likely the leading cause of invasive bacterial disease (20,23). Throughout the 1990s, S. aureus infections in hospitalized patients were increasingly caused by methicillin-resistant S. aureus (MRSA), making treatment of these infections more difficult (20,21,23,40). Moreover, between 1990 and 2005, there was an even more dramatic increase in community-associated MRSA (CA-MRSA) infections (1,5,10,11,19,27,32 In general, surveillance activity for MRSA has been limited to bloodstream or invasive infections and to health care-associated and hospital onset disease, and there have been few populationbased studies. As the epidemiology of S. aureus disease changes, inclusion of community-associated, community onset, and noninvasive disease is important for assessing the magnitude of the burden of disease in the population, for setting priorities for prevention and control, and for creating guidelines for empirical antibiotic treatment.In this retrospective study covering 12 years, we describe laboratory-confirmed S. aureus infections in a large cohort of persons of all ages, using isolates from sterile and nonsterile sites in both ambulatory and inpatient settings. We describe trends in methicillin resistance of laboratory-confirmed S. aureus isolates and trends in the incidence of S. aureus bloodstream infections and explore the relationship of patient demographics and infection onset type to the likelihood of S. aureus infections being methicillin resistant. MATERIALS AND METHODSSetting. Kaiser Permanente of Northern California (KPNC) is a nonprofit, integrated health care delivery system providing care to over 3 million members. The member population reflects the general population in the Northern California region, although as an insured population, it underrepresents persons with annual incomes less than $25,000 (9% of the KPNC member population 25 to 79 years of age versus 21% of the general Northern California population 25 to 79 years of age) and overrepresents persons with annual incomes greater than $100,000 (30% versus 26%). Although racially diverse, the KPNC population also somewhat underrepresents Latinos/Hispanics (19% versus 22%) and overrepresents African-Americans (8% versus 5.5%) (15). KPNC provides services in more than 15 counties and operates more than 40 outpatient clinics and 18 hospitals throughout Northern California. Laboratory results and diagnostic data from hospital discharges and ambulatory settings, including emergency departments, are archived in databases. KPNC databases contain individual patient records and are readily linked using the patient's unique medical record number, which remains with the patient for life.

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Section: Discussionmentioning

confidence: 50%

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Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization

2012

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“…In this American study, the resistances to erythromycin (51.7%), methicillin (27.3%) and clindamycin (23.8%) were the highest. 17 …”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance profile of Staphylococcus aureus isolates obtained from skin and soft tissue infections of outpatients from a university hospital in Recife -PE, Brazil

Caraciolo¹,

Maciel

Santos

et al. 2012

An. Bras. Dermatol.

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BACKGROUNDStaphylococcus aureus has a notable ability to acquire resistance to antibiotics, and methicillin resistance represents a growing public health problem. Methicillin-resistant S. aureus (MRSA) has also become important outside the hospital environment, particularly in the United States. In Brazil, since 2005, cases of community skin infections caused by MRSA have been reported, but resistance studies involving outpatients are scarce.OBJECTIVETo know the resistance profile of S. aureus involved in skin and soft tissue infections of patients seen at the Dermatology outpatient clinic of a university hospital in Recife, Pernambuco State, northeastern Brazil. METHODSProspective study involving 30 patients with skin and soft tissue infections, seen at the Dermatology outpatient clinic from May until November 2011. To evaluate the susceptibility of S. aureus to antibiotics, the disk diffusion method and oxacillin screening agar were used. RESULTSFrom a total of 30 samples of skin lesions, 19 (63%) had positive culture for S. aureus. The following resistance patterns of S. aureus were observed: penicillin, 95%; tetracycline, 32%; erythromycin, 21%; gentamicin, 16%; cefoxitin, 11%; oxacillin, 11%; trimethoprim-sulfamethoxazole, 11%; chloramphenicol, 11%; clindamycin, 5% ; and ciprofloxacin, 0%. One of the identified MRSA was obtained from a patient without risk factors for its acquisition, and was resistant, beyond to the beta-lactams, only to tetracycline. CONCLUSIONSWith regard to the resistance patterns of S. aureus, resistances to tetracycline, erythromycin and gentamicin were the highest. It was documented, for the first time in Pernambuco, a case of skin infection caused by community-associated MRSA.

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“…There are, however, some indications that the rate of MRSA has stabilized or declined in the last few years. One recent national study found that the incidence of healthcare-associated invasive MRSA declined during the period from 2005 to 2008 (Kallen et al, 2010), and an analysis of S. aureus isolates from outpatient pediatric patients with SSTIs found that the percent of isolates that were MRSA was lower in -2009compared to 2005-2007(Diamantis et al, 2011.…”

Section: Introductionmentioning

confidence: 99%

Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus

Ray

Suaya

Baxter

2013

Diagnostic Microbiology and Infectious Disease

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Update on the characterization of Staphylococcus aureus skin infections in a pediatric dermatology tertiary health care outpatient facility: Antibiotic susceptibility patterns and decreased methicillin resistance

Cited by 8 publications

References 6 publications

Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization

Trends and Characteristics of Culture-Confirmed Staphylococcus aureus Infections in a Large U.S. Integrated Health Care Organization

Antimicrobial resistance profile of Staphylococcus aureus isolates obtained from skin and soft tissue infections of outpatients from a university hospital in Recife -PE, Brazil

Microbiology of skin and soft tissue infections in the age of community-acquired methicillin-resistant Staphylococcus aureus

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