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

Abstract

Introduction The emergence of methicillin-resist- ant 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 inpa- tients with MRSA SSTIs from 2011-2015. MRSA infections were classii ed as community-associated (CA-MRSA) and healthcare-associated (HA-MRSA). Demographic characteristics, clinical proi le, 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. The mean age was 41.58 years with male predominance. The ma- jority presented with abscess (62.9%), on the legs (21.8%). The abscess was signii cantly associated with CA-MRSA while infected wounds, previous hospitalization, and surgery were correlated with HA-MRSA. Growing resistance to ciprol oxacin, tet- racycline, macrolides, co-trimoxazole, and clinda- mycin was noted. A low percentage of resistance to vancomycin and linezolid was observed. Almost all cases improved with appropriate antibiotic therapy and 3.3% mortality. Conclusion More than half of the patients with Staphylococcus aureus SSTIs had MRSA. and were mostly CA-MRSA and males. Abscess on the leg was the common presentation and signii cantly as- sociated with CA-MRSA. Infected wounds, previous ciprol oxacin and tetracycline while low resistance to vancomycin and linezolid. Almost all improved with appropriate treatment. Keywords hospitalization, and surgery were associated with HA-MRSA. There was high resistance of MRSA to