Hand infections in Jamaica.

Area of Science:

• Infectious Diseases
• Surgical Infections
• Antimicrobial Stewardship

Background:

• Empirical antibiotic treatment for hand infections is evolving.
• Current trends favor single antibiotic therapy for Staphylococcus aureus in immunocompetent patients.
• Understanding infection characteristics is crucial for effective treatment.

Purpose of the Study:

• To review surgical hand infection cases to determine causative organisms and antibiotic sensitivities.
• To assess the impact of patient factors (e.g., diabetes) and injury mechanisms on infection profiles.
• To inform optimal antibiotic therapy strategies for diverse hand infection scenarios.

Main Methods:

• Retrospective review of 51 surgically treated hand infection patients.
• Analysis of infection site, causative organisms, injury mechanism, and antibiotic sensitivity.
• Comparison of infection characteristics between diabetic and non-diabetic patients.

Main Results:

• Eighty-four percent of non-diabetic patients had single organism infections, predominantly Staphylococcus aureus (59%).
• Fifty percent of diabetic patients presented with polymicrobial infections involving gram-positive and gram-negative organisms.
• Patients with wood-related injuries also exhibited polymicrobial infections.

Conclusions:

• Single antibiotic therapy is appropriate for immunocompetent patients without diabetes, with amoxicillin and clavulanic acid suggested.
• Double antibiotic therapy is recommended for diabetic patients and those with wood-related hand infections due to polymicrobial nature.
• Tailoring antibiotic regimens based on host factors and injury mechanism improves treatment efficacy.