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Am J Surg. 2011 Feb;201(2):216-20. doi: 10.1016/j.amjsurg.2009.12.024. Epub 2010 Sep 15.

Recurrent skin and soft tissue infections due to methicillin-resistant Staphylococcus aureus requiring operative debridement.

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Department of Medicine, University of Texas Southwestern Medical Center, Dallas, USA.



The aim of this study was to examine clinical factors associated with the recurrence of community-onset skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus.


An observational case-comparison study based on a retrospective review of medical records was conducted in a public health system. All patients with community-onset skin and soft tissue infections caused by methicillin-resistant S aureus who underwent operative debridement from January 1999 to December 2003 were included. The outcome of interest was recurrence within 1 year.


Two hundred fifty-three patients met the criteria for inclusion. Fifty-three (21%) patients returned with recurrent episodes. These patients were compared with 200 patients (79%) who did not develop recurrence. On multivariate analysis, factors independently predictive of recurrence were medical history of abscess requiring surgical debridement within the previous year (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-5.0; P = .002) and obesity (adjusted odds ratio, 3.4; 95% confidence interval, 1.4-8.8; P = .008).


Patients with obesity or histories of methicillin-resistant S aureus infection are at significantly increased risk for recurrent soft tissue infection.

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