Hospitalization of paediatric patients for methicillin-resistant Staphylococcus aureus skin and soft-tissue infection, 1998–2006

2009 ◽  
Vol 138 (5) ◽  
pp. 677-682 ◽  
Author(s):  
K. D. SIRCAR ◽  
E. BANCROFT ◽  
D. M. NGUYEN ◽  
L. MASCOLA
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Los Angeles ◽  
Soft Tissue Infection ◽  
International Classification Of Diseases ◽  
Incidence Rates ◽  
Tissue Infection ◽  
Predictive Values ◽  
Methicillin Resistant ◽  
Classification Of Diseases

SUMMARYHospital discharge reports have provided data for studies of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft-tissue infection (SSTI) studies. This analysis determined the sensitivity and positive predictive value of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code combinations to calculate hospitalization incidence rates, representativeness of a set of three ICD-9-CM codes to define MRSA SSTI, and hospitalization incidence rate trends for paediatric MRSA SSTIs in Los Angeles County (LAC). Using 133 cases from 31 hospitals, we found that the set of three ICD-9-CM codes used to define laboratory-confirmed cases had one of the highest positive predictive values (49%). There was no difference in age and race between those categorized using three codes vs. other code combinations. A dramatic increase in paediatric MRSA SSTI cases occurred in LAC during 1998–2006. We conclude that this combination of codes may be used to determine the rise of MRSA SSTIs in paediatric populations.

scholarly journals Risk Factors Associated With Methicillin-Resistant Staphylococcus aureus (MRSA) Complicated Skin and Soft Tissue Infection in Colombia

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Sandra Liliana Valderrama Beltran ◽  
Sandra Gualtero ◽  
Jose Rodriguez ◽  
Johanna Osorio ◽  
Carlos Arturo Alvarez Moreno ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tissue Infection ◽  
Methicillin Resistant ◽  
Factors Associated ◽  
Complicated Skin

scholarly journals HOME2 Study: Household Versus Personalized Decolonization in Households of Children With Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Infection—A Randomized Clinical Trial

2020 ◽  
Author(s):  
Patrick G Hogan ◽  
Katelyn L Parrish ◽  
Ryan L Mork ◽  
Mary G Boyle ◽  
Carol E Muenks ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tissue Infection ◽  
Methicillin Resistant ◽  
Home Study ◽  
Intranasal Mupirocin ◽  
Household Members ◽  
Personalized Approach

Abstract Background A household approach to decolonization decreases skin and soft tissue infection (SSTI) incidence, though this is burdensome and costly. As prior SSTI increases risk for SSTI, we hypothesized that the effectiveness of decolonization measures to prevent SSTI when targeted to household members with prior year SSTI would be noninferior to decolonizing all household members. Methods Upon completion of our 12-month observational Household Observation of Methicillin-resistant Staphylococcus aureus in the Environment (HOME) study, 102 households were enrolled in HOME2, a 12-month, randomized noninferiority trial. Pediatric index patients with community-associated methicillin-resistant Staphylococcus aureus (MRSA) SSTI, their household contacts, and pets were enrolled. Households were randomized 1:1 to the personalized (decolonization performed only by household members who experienced SSTI during the HOME study) or household (decolonization performed by all household members) approaches. The 5-day regimen included hygiene education, twice-daily intranasal mupirocin, and daily bleach-water baths. At 5 follow-up visits in participants’ homes, swabs to detect S. aureus were collected from participants, environmental surfaces, and pets; incident SSTIs were ascertained. Results Noninferiority of the personalized approach was established for the primary outcome 3-month cumulative SSTI: 23 of 212 (10.8%) participants reported SSTI in household approach households, while 23 of 236 (9.7%) participants reported SSTI in personalized approach households (difference in proportions, −1.1% [95% confidence interval, −6.7% to 4.5%]). In multivariable analyses, prior year SSTI and baseline MRSA colonization were associated with cumulative SSTI. Conclusions The personalized approach was noninferior to the household approach in preventing SSTI. Future studies should interrogate longer durations of decolonization and/or decontamination of the household environment to reduce household MRSA burden. Clinical Trials Registration NCT01814371.

scholarly journals Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department

CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 430-438 ◽  
Author(s):  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Marc Romney ◽  
John Fahimi ◽  
Devin Harris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infection ◽  
Tissue Infection ◽  
Methicillin Resistant ◽  
Period Prevalence ◽  
Monthly Period ◽  
Mrsa Infection

ABSTRACT Objective: We sought to estimate the period prevalence of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infection (SSTI) and evaluate risk factors for MRSA SSTI in an emergency department (ED) population. Methods: We carried out a cohort study with a nested case–control design. Patients presenting to our ED with a wound culture and a discharge diagnosis of SSTI between January 2003 and September 2004 were dichotomized as MRSA positive or negative. Fifty patients with MRSA SSTI matched by calendar time to 100 controls with MRSA-negative SSTI had risk factors assessed using multivariate conditional logistic regression. Results: Period prevalence of MRSA SSTI was 54.8% (95% confidence interval [CI] 50.2%–59.4%). The monthly period prevalence increased from 21% in January 2003 to 68% in September 2004 (p < 0.01). Risk factors for MRSA SSTI were injection drug use (IDU) (odds ratio [OR] 4.6, 95% CI 1.4–16.1), previous MRSA infection and colonization (OR 6.4, 95% CI 2.1–19.8), antibiotics in 8 weeks preceding index visit (OR 2.6, 95% CI 1.2–8.1), diabetes mellitus (OR 4.1, 95% CI 1.4–12.1), abscess (OR 5.6, 95% CI 1.8–17.1) and admission to hospital in previous 12 months (OR 2.6, 95% CI 1.1–11.2). Conclusion: The period prevalence of MRSA SSTI between January 2003 and September 2004 was 54.8% at our institution. There was a marked increase in the monthly period prevalence from the beginning to the end of the study. Risk factors are IDU, previous MRSA infection and colonization, prescriptions for antibiotics in previous 8 weeks and admission to hospital in the preceding 12 months. On the basis of local prevalence and risk factor patterns, emergency physicians should consider MRSA as a causative agent for SSTI.

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