362. Antibiotics For MRSA Skin And Soft Tissue Infections: The Challenge Of Outpatient Therapy
Session: Poster Abstract Session: MRSA, MSSA, Enterococci
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
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  • Background:

    Methicillin-resistant Staphylococcus aureus (MRSA) infections are becoming increasingly prevalent in both community and hospital settings. Certain strains are notorious for causing skin and soft tissue infections in patients with no established risk factors. In this article, we report our findings on the dynamic antibiotic resistance pattern of MRSA within our community.

    Methods:

    We conducted a retrospective chart-review of 1,876 patients evaluated in the emergency department of a busy 363-bed urban community hospital from 2003-2012. Data regarding culture isolates and associated antimicrobial resistance, antibiotic treatment (given with seven days of specimen collection), site of specimen collection, diabetic status, age, race, and gender were collected and analyzed.

    Results:

    A total of 2,193 isolates were identified. In some cases, a single specimen yielded polymicrobial growth. Staphylococcus aureus represented 996 isolates; 463 were methicillin-susceptible (46.5%) and 533 (53.5%) were methicillin-resistant. 60 patients with MRSA (11.3%) had a diagnosis of diabetes mellitus at the time of specimen collection. Treatment most often consisted of trimethoprim/sulfamethoxazole (TMP/SMX), cephalexin, and clindamycin, prescribed either singly or in combination. Antimicrobial resistance analysis indicated that MRSA became increasingly resistant to the aforementioned antibiotics over time: 10% and 6% in 2012 vs 3.5% and 3.4% in 2007 for clindamycin and TMP/SMX, respectively.

    Conclusion:

    MRSA is a particularly virulent, rapidly adaptive pathogen that is becoming increasingly difficult to combat with existing antibiotics. Care must be taken to ensure appropriate treatment and follow-up of patients with known MRSA infections.

    Amy Pate, MD1, Hossein Kalantari, MD, MPH2 and Getaw Worku Hassen, MD, PhD2, (1)Emergency Medicine, Metropolitan Hospital Center, New York, NY, (2)Emergency Medicine, New York Medical College/Metropolitan Hospital Center, New York, NY

    Disclosures:

    A. Pate, None

    H. Kalantari, None

    G. W. Hassen, None

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