Risk factors for methicillin-resistant <i>Staphylococcus aureus</i> skin and soft-tissue infections in outpatients in Taiwan

Chou, Ya-Hui; Lee, M.-S.; Lin, Ruey S.; Wu, Chien-Tung

doi:10.1017/s0950268814001642

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…In this study it was found that the risk factors for MRSA vs. non-MRSA SSTI in hospitalized patients were the presence of abscess, cellulitis, age of 18-44 years, and previous outpatient antibiotic treatment. Some of the risk factors identified in this study are similar to those reported in other studies performed in the USA, Canada, and Taiwan, in which purulent infections (abscesses and purulent cellulitis) (Moran et al, 2006;Haysom et al, 2018) and previous use of antibiotics were associated with MRSA (Moran et al, 2006;Skiest et al, 2007;Stenstrom et al, 2009;Chou et al, 2015). In the present study, diabetes, intravenous drug use, female sex, HIV infection, and athletic team participation (Hota et al, 2007) were not associated with MRSA SSTI, in contrast to the findings of studies in the USA, Canada, and the Middle East (Stenstrom et al, 2009;Ray et al, 2013a;Al Jalaf et al, 2018).…”

Section: Discussionsupporting

confidence: 88%

“…In Colombia, it is common for clinicians to prescribe penicillins for SSTIs, specifically amoxicillin, amoxicillinclavulanic acid, and dicloxacillin. This finding is similar to those of studies performed in the Middle East and Asia (Chou et al, 2015;Al Jalaf et al, 2018) and in contrast to the findings of other studies in Europe and the USA (Lipsky et al, 2007;Macía-Rodríguez et al, 2017), where an increase in prescription of antibiotics active against MRSA (Szumowski et al, 2007;Hersh, 2008) was noted in emergency rooms in the last decades (Pallin et al, 2008). A systematic review by Abetz et al reported a frequency of treatment failure of 15-38% in SSTI, and an MRSA infection was implicated in this outcome (Abetz et al, 2018).…”

Section: Discussionsupporting

confidence: 87%

“…For this reason, we excluded negative culture SSTI from the risk factor analysis of MRSA vs. non-MRSA SSTI. Second, previous contact with someone with a similar skin condition or surgery, nasal carriage of MRSA, and a history of SSTI were not assessed, which have been described as risk factors for MRSA SSTI (Skiest et al, 2007;Stenstrom et al, 2009;Chou et al, 2015). Third, this study did not include molecular analysis to confirm the characteristics of the MRSA isolates, since the isolates were not stored for further characterization.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Valderrama-Beltrán

Gualtero

Álvarez-Moreno

et al. 2019

International Journal of Infectious Diseases

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Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) represent a major clinical problem in Colombia. The aim of this study was to evaluate the risk factors associated with MRSA SSTI in Colombia. Methods: A multicenter cohort study with nested case-control design was performed. Patients with an SSTI with at least 48 h of inpatient care were included. Patients with an MRSA SSTI were considered the case group and patients with either a non-MRSA SSTI or with an Methicillin-susceptible S. aureus (MSSA) SSTI were the control groups. A multivariate logistic regression approach was used to evaluate risk factors associated with MRSA SSTI with two different statistical models. Results: A total 1134 patients were included. Cultures were positive for 498 patients, of which 52% (n = 259) were Staphylococcus aureus. MRSA was confirmed in 68.3% of the S. aureus cultures. In the first model, independent risk factors for MRSA SSTI were identified as the presence of abscess (P < 0.0001), cellulitis (P = 0.0007), age 18-44 years (P = 0.001), and previous outpatient treatment in the previous index visit (P = 0.003); surgical site infection was a protective factor (P = 0.008). In the second model, the main risk factor found was previous outpatient treatment in the previous index visit (P = 0.013). Conclusions: Community-acquired SSTIs in Colombia are commonly caused by MRSA. Therefore, clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTI in Colombia, although there seems to be low awareness of this fact.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

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Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Valderrama-Beltrán

Gualtero

Álvarez-Moreno

et al. 2019

International Journal of Infectious Diseases

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“…It may be also involved in systemic infections [61,62]. The pathogen commonly found in acute and chronic infections of the hearing aid with both children [63,64] and adults [65,66]. reported that the implant-associated infection with S. aureus bacteria is developed in 15 out of 44 patients with prosthetic joints [74].…”

Section: Staphylococcus Aureus Germs Are Often Involved In Local Imentioning

confidence: 99%

Influence of Ag content on the antibacterial properties of SiC doped hydroxyapatite coatings

Badea

Braic

Kiss

et al. 2016

Ceramics International

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“…In the USA, colonization by S. aureus is high among SSTI patients, particularly that of USA300 MRSA [ 2 ]. In Taiwan, the prevalence of MRSA in most of the major hospitals ranged from 53 % to 83 % [ 3 ]; MRSA is a major pathogen related to SSTIs [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic susceptibility and genomic variations in Staphylococcus aureus associated with Skin and Soft Tissue Infection (SSTI) disease groups

Changchien¹,

Chen²,

Chen³

et al. 2016

BMC Infect Dis

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BackgroundStaphylococcus aureus is associated with human skin and soft tissue infections (SSTIs); however, the involvement of virulence factors in different clinical presentations is unclear.MethodsWe analyzed methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains from Taiwan to determine correlations among the clinical characteristics of SSTIs, antimicrobial susceptibility and virulence factors of S. aureus with specific genetic backgrounds.ResultsWe identified 177 MRSA isolates and 130 MSSA isolates among the 307 SSTI-associated S. aureus isolates. Hospital-acquired (HA)- and community-acquired (CA)-MRSA isolates accounted for 61.6 % and 38.4 % of the isolates, respectively. Clinical presentations in SSTI patients differed significantly for the disease groups. Deep-seated MRSA infections presented with higher amputation rate than MSSA infections. MRSA isolates were all susceptible to linezolid, teicoplanin, and vancomycin, and >94 % of isolates were erythromycin- and clindamycin-resistant. Staphylococcal cassette chromosome (SCCmec) types IV, V, and VII were the most frequent in the CA-MRSA group (n = 68); types III, IV and V were the most frequent in the HA-MRSA group (n = 109). Panton-Valentine leukocidin (PVL) genes were significantly more frequent in CA-MRSA strains (75.0 %) than in HA-MRSA (33.0 %) and MSSA (24.6 %) and were found in 66.7 % (74/111) strains isolated from the abscess group. Exfoliatin A genes were more common in catheter-related exit-site MSSA infections (37.5 %) compared with other MSSA disease groups (P < 0.05). Exfoliatin B and superantigen exotoxin genes were uncommon in all SSTI disease types. Pulsotypes A (ST239), C, and D (ST59) were the predominant MRSA genotypes in deep-seated infections.ConclusionsIf not treated appropriately, deep-seated MRSA-associated infections present with higher amputation rates than deep-seated MSSA-associated infections. PVL-positive MRSA strains caused more frequently pus-forming lesions and less bacteremia and invasive diseases. Methods for discriminating CA-MRSA from HA-MRSA strains are now unreliable due to circulation of both ST 239 and ST 59 strains in the community and nosocomial settings. Initial antibiotic treatments should consider MRSA for patients with SSTIs in areas where MRSA is prevalent.

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Risk factors for methicillin-resistant Staphylococcus aureus skin and soft-tissue infections in outpatients in Taiwan

Cited by 11 publications

References 15 publications

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Influence of Ag content on the antibacterial properties of SiC doped hydroxyapatite coatings

Antibiotic susceptibility and genomic variations in Staphylococcus aureus associated with Skin and Soft Tissue Infection (SSTI) disease groups

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