Community-acquired methicillin-resistant Staphylococcus aureus skin infection: a retrospective analysis of clinical presentation and treatment of a local outbreak.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA), a well-known nosocomial pathogen, is now emerging as a prominent cause of community acquired infections. We have noted an increase in number of cutaneous infections in Los Angeles over the past 2 years. The objective of the current study is to evaluate the clinical presentation and treatment of community acquired MRSA skin infections. A retrospective chart review of 39 patients with 46 involved sites was performed. The sites of infection, morphology, antimicrobial susceptibility, and definitive treatment were evaluated. Cutaneous abscesses were the most common presentation of cutaneous MRSA infection. Definitive treatment consisted of incision and drainage in combination with antimicrobial therapy. The most effective antibiotics were vancomycin, trimethoprim/sulfamethoxazole in combination with rifampin, and linezolid. Community acquired MRSA infection appears to be a growing problem requiring prompt diagnosis and treatment. First line treatment is incision and drainage in combination with linezolid, vancomycin, or combination trimethoprim/sulfamethoxazole and rifampin.