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COMMUNITY ACQUIRED METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS HAND INFECTIONS: A SOUTH PACIFIC PERSPECTIVE — CHARACTERISTICS AND IMPLICATIONS FOR ANTIBIOTIC COVERAGE

Derek Buchanan

Auckland Regional Plastic, Reconstructive and Hand Surgery Unit, Middlemore Hospital, New Zealand

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Wolfgang Heiss-Dunlop

Auckland Regional Plastic, Reconstructive and Hand Surgery Unit, Middlemore Hospital, New Zealand

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and

Jon A. Mathy

Auckland Regional Plastic, Reconstructive and Hand Surgery Unit, Middlemore Hospital, New Zealand

University of Auckland, New Zealand

Correspondence to: Dr. Jon A. Mathy, Auckland Regional Plastic, Reconstructive and Hand Surgery Unit, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland 1640, New Zealand. Tel: (+64) 09-276-0000 (ext. 8755), Fax: (+64) 09-276-0004.

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https://doi.org/10.1142/S0218810412500244Cited by:3

Abstract

Purpose: Community acquired methicillin resistant Staphylococcus aureus (CA-MRSA) infections are reported to be increasing worldwide. In the United States when rates exceed 15% empiric treatment is suggested. The aim of our study was to determine local rates and treatment of CA-MRSA within our region.

Methods: Nine hundred and forty-two patients were admitted to our service during a six-year period with culture-positive hand infections identified from operative cultures at the time of surgery.

Results: Sixty-six (7.0%) patients had CA-MRSA positive cultures identified. Thirty-two (48.5%) patients were noted to have remained on antibiotic treatment that did not reflect their MRSA positive status after cultures returned. Despite this, re-admission and re-operation rates were low and comparable to our non-MRSA control group.

Conclusions: Within our CA-MRSA group, current rates do not support automatic empiric treatment for CA-MRSA. Based on sensitivity data, co-trimoxazole and intravenous vancomycin are appropriate and effective antibiotic treatment within our region. Our data supports the importance of drainage of pyogenic infections in helping to resolve complicated hand infections.

This paper was presented, in part, at the 2011 LMT Principles and Practice of Upper Limb Repair and Reconstruction, Fiji, July 7–10, 2011; and, in part, at the 2010 Annual Scientific Meeting of the New Zealand Association of Plastic Surgeons, Auckland, New Zealand, November 27, 2010.

Keywords:

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Vol. 17, No. 03

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Received 23 January 2012

Revised 11 March 2012

Accepted 11 March 2012

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COMMUNITY ACQUIRED METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS HAND INFECTIONS: A SOUTH PACIFIC PERSPECTIVE — CHARACTERISTICS AND IMPLICATIONS FOR ANTIBIOTIC COVERAGE

Abstract

References

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