PURPOSE: To report a local outbreak of community-associated methicillin-resistant Staphylococcus aureas (CA-MRSA), discuss the incidence and the high rates of CA-MRSA-related skin and soft tissue infections in our outpatient and emergency department (ED) population, and also review the diagnosis and management of CA-MRSA in outpatients. DATA SOURCES: Case report, diagnostic evidence, scientific literature, published treatment guidelines, and a retrospective chart review. CONCLUSIONS: Clinical suspicions of high rates of CA-MRSA-related skin and soft tissue infections in our institution's outpatient and ED population was supported. Hospital-acquired MRSA (HA-MRSA) was also more prevalent than expected. Recognizing high-risk settings, patients and clinical features of CA-MRSA is essential for early identification and proper management. The most common clinical manifestation of CA-MRSA we identified was a skin or soft tissue infection. IMPLICATIONS FOR PRACTICE: It is important that clinicians have an awareness of high-risk patients, perform routine culturing of soft tissue infections, and prescribe antibiotics based on culture and sensitivities. Awareness, prevention, early diagnosis, and implementation of effective antibiotic management by nurse practitioners can help limit an epidemic of CA-MRSA.
PURPOSE: To report a local outbreak of community-associated methicillin-resistant Staphylococcus aureas (CA-MRSA), discuss the incidence and the high rates of CA-MRSA-related skin and soft tissue infections in our outpatient and emergency department (ED) population, and also review the diagnosis and management of CA-MRSA in outpatients. DATA SOURCES: Case report, diagnostic evidence, scientific literature, published treatment guidelines, and a retrospective chart review. CONCLUSIONS: Clinical suspicions of high rates of CA-MRSA-related skin and soft tissue infections in our institution's outpatient and ED population was supported. Hospital-acquired MRSA (HA-MRSA) was also more prevalent than expected. Recognizing high-risk settings, patients and clinical features of CA-MRSA is essential for early identification and proper management. The most common clinical manifestation of CA-MRSA we identified was a skin or soft tissue infection. IMPLICATIONS FOR PRACTICE: It is important that clinicians have an awareness of high-risk patients, perform routine culturing of soft tissue infections, and prescribe antibiotics based on culture and sensitivities. Awareness, prevention, early diagnosis, and implementation of effective antibiotic management by nurse practitioners can help limit an epidemic of CA-MRSA.
Authors: Dawn M Sievert; Mark L Wilson; Melinda J Wilkins; Brenda W Gillespie; Matthew L Boulton Journal: Am J Public Health Date: 2010-07-15 Impact factor: 9.308