1167. Risk Factors Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Complicated Skin and Soft Tissue Infection (CSSTIs) in Colombia
Session: Poster Abstract Session: Clinical Infectious Diseases: Bone and Joint, Skin and Soft Tissue
Friday, October 28, 2016
Room: Poster Hall
Posters
  • poster SSTI S. aureus Colombia.pdf (171.6 kB)
  • Background:Skin and soft tissue infections (SSTI) caused by Staphylococcus aureus represent a growing problem in Colombia due to the massive dissemination of a community-associated (CA) strain designated MRSA USA300 Latin American Variant. The aim of this study was to evaluate risk factors associated with complicated Infection of Skin and Soft Tissue (CSSTIs) caused by CA-Methicillin-Resistant Staphylococcus aureus in Colombia

    Methods: A cohort study with a nested case-control design was carried in 13 hospitals in Colombia between January 2009 and June 2015. We included patients aged ≥ 18 years with complicated SSTI who required at least 48 hours of inpatient care or patients with hospital-acquired SSTI. Patients with osteoarticular infections, burns or viral infections were excluded. Case patients where defined as having a MRSA SSTI and control as those with SSTI caused by other microorganism.

    Results: A total of 1134 patients were included with 177 (15.6%) patients in which Methicillin-Resistant Staphylococcus aureus was isolated. Multivariate logistic regression identified the following risk factors for MRSA infection: abscesses [odds risk (OR) 2.54, 95 % confidence interval (CI) 1.79 - 3.61], forunculosis [OR 3.79, 95% CI 1.04-13,85], age 18 - 44 years [OR 2.46, 95% CI 1.55-3,93], previous management in outpatient setting [OR 1.76, 95% CI 1.14 - 2.71] and history of bite [OR 1.98, 95% CI 1,08-3.62]. Of note, 57% patients received inappropriate therapy for MRSA.

    Conclusion:

    Complicated Skin and Soft Tissue Infection (CSSTIs) caused by MRSA in Colombia mainly affect young patients and is often associated with abscesses. Previous management in outpatient settings is an important risk factor for MRSA acquisition. Although clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTIs, there seems to be low awareness of this fact in Colombia.

    Sandra Liliana Valderrama Beltran, MD1, Sandra Gualtero, MD2, Jose Rodriguez, MD3, Johanna Osorio, MD4, Carlos Arturo Alvarez Moreno, Physician infectious diseases5, Fabian Gil, MD6, Carlos Gomez Quintero, MD7, Maria Alejandra Caro, MD2, Sebastian Mackenzie, MD2, Gerson Arias, MD8 and Cesar Arias, MD, PhD, FIDSA9, (1)Infectious Diseases, hospital universitario san ignacio, bogota, Colombia, (2)Hospital Universitario San Ignacio, Bogota, Colombia, (3)Hospital Rosario Pumarejo Lopez, Valledupar, Colombia, (4)Hospital Universitario Hernando Moncaleano Perdomo, Neiva, Colombia, (5)Infectious Diseases, Hospital Universitario San Ignacio, Bogotá, Colombia, (6)Universidad Javeriana, Bogota, Colombia, (7)Clinica de la Mujer, BOGOTA, Colombia, (8)Hospital Santa Clara, Bogota, Colombia, (9)Department of Internal Medicine, University of Texas McGovern Medical School at Houston, Houston, TX

    Disclosures:

    S. L. Valderrama Beltran, None

    S. Gualtero, None

    J. Rodriguez, None

    J. Osorio, None

    C. A. Alvarez Moreno, None

    F. Gil, None

    C. Gomez Quintero, None

    M. A. Caro, None

    S. Mackenzie, None

    G. Arias, None

    C. Arias, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.