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Clin Infect Dis. 2007 Feb 15;44(4):483-92. Epub 2007 Jan 12.

A prospective investigation of outcomes after hospital discharge for endemic, community-acquired methicillin-resistant and -susceptible Staphylococcus aureus skin infection.

Author information

1
Division of Infectious Diseases, Harbor-University of California-Los Angeles (UCLA) Medical Center, Torrance, CA 90509, USA. lgmiller@ucla.edu

Abstract

BACKGROUND:

Although community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has become increasingly common, prospective data on outcomes of patients with skin infection remain poorly defined.

METHODS:

We prospectively observed a cohort of 201 patients discharged after hospitalization for CA-MRSA infection or community-acquired methicillin-susceptible S. aureus (CA-MSSA) infection. Patients were interviewed 30 and 120 days after they received a diagnosis. Our primary outcome was clinical response, defined as no relapse, new S. aureus infection, or need for antibiotics at day 30.

RESULTS:

Among 117 patients with skin infection, the nonresponse rate at day 30 was similar among patients with CA-MRSA infection and those with CA-MSSA infection (23 [33%] of 70 vs. 13 [28%] of 47 patients; P=.55). Lack of incision and drainage was associated with nonresponse at day 30 (P=.005), but other clinical factors, including receipt of antibiotics inactive against the infecting strain, were not. Patients with CA-MSSA infection were more likely to be rehospitalized (P=.003) and to believe subjectively that they had not been cured (P=.002) at day 30. At day 30, there was a trend for close contacts of CA-MRSA-infected patients to develop a similar infection (13% vs. 4%; odds ratio, 3.3; 95% confidence interval, 0.7-15.8; P=.2).

CONCLUSION:

Although it is believed patients with CA-MRSA skin infection may have more serious outcomes than those with CA-MSSA skin infection, we found similar outcomes in these 2 groups after hospital discharge. Clinical nonresponse at day 30 was associated with a lack of receipt of incision and drainage. Our data also suggest that close contacts of persons with CA-MRSA skin infection may have a higher likelihood of acquiring an infection.

PMID:
17243049
DOI:
10.1086/511041
[Indexed for MEDLINE]

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