Research ArticleOriginal Research

Prevalence, Severity, and Treatment of Community-Acquired Methicillin-Resistant Staphylococcus Aureus (CA-MRSA) Skin and Soft Tissue Infections in 10 Medical Clinics in Texas: A South Texas Ambulatory Research Network (STARNet) Study

Nicolas A. Forcade, Michael L. Parchman, James H. Jorgensen, Liem C. Du, Natalie R. Nyren, Lucina B. Treviño, Joel Peña, Michael W. Mann, Abilio Muñoz, Sylvia B. Treviño, Eric M. Mortensen, Brian L. Wickes, Brad H. Pollock and Christopher R. Frei
The Journal of the American Board of Family Medicine September 2011, 24 (5) 543-550; DOI: https://doi.org/10.3122/jabfm.2011.05.110073

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Wound characteristics for patients with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI), n = 73.

  • Figure 2.
    Figure 2.

    Infected body sites for patients with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI), n = 73.

  • Figure 3.
    Figure 3.

    Infection severity for patients with community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI), n = 70. *Moderate or complicated infections were defined by the presence of either a lesion ≥ 5 cm or a patient history of diabetes. Lesion size was missing for 3 patients.

  • Figure 4.
    Figure 4.

    Treatment approach for patients with community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA) skin and soft-tissue infections (SSTI), n = 72. *Treatment approach was unavailable for 1 patient.

  • Figure 5.
    Figure 5.

    Antibiotics prescribed for patients with community-acquired methicillin-resistant Staphylococcus aureus(CA-MRSA) skin and soft-tissue infections (SSTI), n = 64. *Antibiotics were not available for 9 patients. †Combination therapy = trimethoprim-sulfamethoxazole (TMP-SMX) + β-lactam (4/9), TMP-SMX + clindamycin (2/9), TMP-SMX + doxycycline (2/9), clindamycin + mupirocin (1/9).

Tables

  • Table 1.

    Patient Demographics

    CharacteristicOverall (n = 119)MRSA (n = 73)Non-MRSA (n = 46)
    Sex, %
        Male61 (51%)36 (49%)25 (54%)
        Female58 (49%)37 (51%)21 (46%)
    Race,* %
        Black8 (8%)4 (7%)4 (10%)
        White70 (72%)42 (71%)28 (72%)
        Other20 (20%)13 (22%)7 (18%)
    Ethnicity,† %
        Hispanic90 (82%)55 (79%)35 (88%)
        Non-Hispanic20 (18%)15 (21%)5 (12%)
    BMI‡ (kg/m2), median (IQR)31 (25 to 37)30 (25 to 36)31 (23 to 38)
    Risk factors, %
        Diabetes31 (26%)22 (30%)9 (20%)
        Provides healthcare to others5 (4%)2 (3%)3 (7%)
        SSTI within past 12 months52 (44%)28 (38%)24 (52%)
        Received antibiotics for SSTI within past 12 months22 (18%)14 (19%)8 (17%)
        MRSA SSTI within past 12 months10 (8%)5 (7%)5 (11%)
        SSTI within past 90 days19 (16%)11 (15%)8 (17%)

    • MRSA, methicillin-resistant Staphylococcus aureus; BMI, body mass index. IQR, interquartile range; SSTI, skin and soft-tissue infections.

    • ↵* Race missing for 14 MRSA-positive and 7 MRSA-negative patients.

    • ↵† Ethnicity missing for 3 MRSA-positive and 6 MRSA-negative patients.

    • ↵‡ BMI missing for 37 MRSA-positive and 18 MRSA-negative patients.

  • Table 2.

    Microbiologic Data for Patients With community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin and soft-tissue infections (SSTI), n = 73

    AntibioticMIC50 (μg/mL)MIC90 (μg/mL)% of Isolates Susceptible
    TMP-SMX0.060.12100
    Doxycycline0.060.06100
    Clindamycin0.060.1293
    Linezolid1.02.0100
    Vancomycin2.02.0100

    • TMP-SMX, trimethoprim-sulfamethoxazole.

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