Program Schedule

282
Epidemiology of Skin and Soft-Tissue Infections in US Army Trainees at Fort Benning

Session: Poster Abstract Session: MRSA and VRE
Thursday, October 9, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • 282_IDWPOSTER.pdf (803.7 kB)
  • Background: Soldiers in training are at high risk for skin and soft-tissue infection (SSTI), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA). Robust epidemiological, microbiological, and molecular data are vital to developing prevention strategies. The objective of this investigation was to describe the epidemiology and clinical characteristics of SSTI in a high MRSA setting.

    Methods: In July 2012, we initiated a prospective observational cohort study among US Army Infantry trainees at Fort Benning, GA to determine overall and MRSA SSTI incidence and to describe the clinical characteristics of disease. Clinical S. aureus isolates underwent molecular characterization, including pulsed-field gel electrophoresis (PFGE).

    Results: From July 2012 through July 2013, 25,181 trainees completed 14-week Infantry training. Of those trainees, 846 developed SSTI for an overall rate of 0.04 per 100 person-days. The MRSA SSTI rate was 0.01 per 100 person-days. Rates of SSTI were highest during the summer months. The median interval from training start to clinical presentation for SSTI was 40 (range 0-108) days. The most frequent clinical manifestations were cellulitis (48.7%) and abscess (32.4%) with the majority (65.5%) of infections on the lower extremities. Of the 846 SSTI subjects, 464 clinical specimens were collected, of which 388 (83.6%) were culture-positive for S. aureus, with MRSA accounting for 60.1%. Of the 180 MRSA isolates available for analysis, 165 (91.7%) were pulsed-field type USA300. 

    Conclusion: Skin and soft-tissue infections continue to impose a substantial burden in the trainee population. The epidemiology is dynamic, but USA300 MRSA continues as the predominant SSTI genotype. Effective strategies for SSTI prevention in this and other high-risk settings are critically needed.

    Michael Ellis, MD1, Carey Schlett, MPH2, Tianyuan Cui, MA2, Eugene Millar, PhD2, Katrina Crawford, MS2, Jeffrey Lanier, MD3, Natasha Law, MA2, Nimfa Teneza-Mora, MD MPH4, Eric Hall, PhD4, D. Scott Merrell, PhD5 and David Tribble, MD, DrPH2, (1)Department of Medicine, Uniformed Services University, Bethesda, MD, (2)Infectious Disease Clinical Research Program, Uniformed Services University, Rockville, MD, (3)Family Medicine, Martin Army Community Hospital, Fort Benning, GA, (4)Naval Medical Research Center, Silver Spring, MD, (5)Department of Microbiology, Uniformed Services University, Bethesda, MD

    Disclosures:

    M. Ellis, None

    C. Schlett, None

    T. Cui, None

    E. Millar, None

    K. Crawford, None

    J. Lanier, None

    N. Law, None

    N. Teneza-Mora, None

    E. Hall, None

    D. S. Merrell, None

    D. Tribble, None

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