Retrospective analysis of methicillin-resistant Staphylococcus aureus skin and soft tissue infection among patients admitted at an Academic University Hospital from 2011 to 2015: a five-year review


Introduction: The emergence of methicillin resistant Staphylococcus aureus (MRSA) is a challenge in the management of skin and soft tissue infections (SSTIs).

Objective: To describe the epidemiology of MRSA SSTIs among admitted patients at the University of Santo Tomas Hospital (USTH).

Methods: This was a retrospective study of inpatients with MRSA SSTIs from 2011-2015. MRSA infections were classified as community-associated (CA-MRSA) and healthcare-associated (HA-MRSA). Demographic characteristics, clinical profile, co-morbidities, complications, risk factors, antibiotic susceptibility and resistance, treatment used and clinical outcome were determined.

Results: Out of the 331 inpatients with Staphylococcus aureus SSTIs, 211 had MRSA, with a prevalence of 63.7%. 80.1% of MRSA were CA-MRSA while 19.9% were HA-MRSA. Mean age was 41.58 years with male predominance. Majority presented with abscess (62.9%), on the legs (21.8%). Abscess was significantly associated with CA-MRSA while infected wounds, previous hospitalization and surgery were correlated with HA-MRSA. A growing resistance to ciprofloxacin, tetracycline, macrolides, co-trimoxazole and clindamycin was noted. Low percentage of resistance to vancomycin and linezolid was observed. Almost all cases improved with appropriate antibiotic therapy with 3.3% mortality.

Conclusion: More than half of patients with Staphylococcus aureus SSTIs had MRSA. Mostly were CA-MRSA and males. Abscess on the leg was the common presentation and significantly associated with CA-MRSA. Infected wounds, previous hospitalization and surgery were associated with HA-MRSA. There was a high resistance of MRSA to ciprofloxacin and tetracycline while low resistance to vancomycin and linezolid. Almost all improved with appropriate treatment.

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