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Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections of the Hand: Prevalence and Timeliness of Treatment
Journal article   Peer reviewed

Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections of the Hand: Prevalence and Timeliness of Treatment

Michael O'Malley, John Fowler and Asif M. Ilyas
The Journal of hand surgery (American ed.), v 34A(3), pp 504-508
01 Mar 2009
DOI: https://doi.org/10.1016/j.jhsa.2008.11.021
PMID: 19258149
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology Surgery
Purpose The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (ca-MRSA) appears to be increasing, but the timeliness of appropriate antibiotic delivery is often delayed. We. retrospectively reviewed the prevalence of ca-MRSA infections in an urban setting, time from presentation to the hospital to appropriate antibiotic delivery, and differences in length of stay between the ca-MRSA and non-MRSA hand infections. Methods We retrospectively reviewed all visits for hand infection cases to the emergency room of an urban academic medical center over a 12-month period. A formal hand infection algorithm was used in the treatment of each patient. All patients with culture-positive hand infections were included for evaluation. Infections determined to be nosocomial or not community-acquired were excluded. Patient demographics, laboratory studies, culture results, antibiotic delivery, and length of stay data were collected. Results A total of 85 patients (55 male) with an average age of 39 years met the inclusion criteria. The overall prevalence rate of ca-MRSA hand infections was 55%. The average time to appropriate antibiotic delivery for ca-MRSA infection was 12 hours, versus 2.64 hours for non-MRSA hand infections (p > .5). The average length of stay was 4.0 days for ca-MRSA infections and 3.5 days for non-MRSA infections (p > .05). Univariate and multivariate analysis identified intravenous drug abuse and a serum white blood cell count of >8.7 as independent risk factors for ca-MRSA hand infections. Conclusions Community-acquired methicillin-resistant S. aureus infections of the hand continue to increase in urban settings. With the use of a formal hand infection treatment algorithm, we did not identify a statistical difference in appropriate antibiotic delivery time and length of stay between ca-MRSA and non-MRSA hand infections. (J Hand Surg 2009; 34A:504-508. (C) 2009 Published by Elsevier hoc. on behalf of the American Society for Surgery of the Hand.)

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Web of Science research areas
Orthopedics
Surgery
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