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Updated: Jul 16, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Increasing incidence of methicillin-resistant Staphylococcus aureus in hand infections: a 3-year county hospital
Danielle M LeBlanc1, Edward M Reece, J Bauer Horton
1Department of Plastic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX 75235-9132, USA.
Background:
Staphylococcus aureus is the most common cause of skin and soft-tissue infections. Methicillin-resistant S. aureus and community-acquired methicillin-resistant S. aureus have shown an increase in prevalence among soft-tissue infections over the past several years, with overall rates approaching 50 percent at the authors' institution in 2002. The object of this study was to determine the incidence of methicillin-resistant S. aureus with respect to hand infections, the antibiotic resistance pattern of methicillin-resistant S. aureus isolates, and implications for a change in antibiotic treatment algorithms for hand infections.
Methods:
A retrospective chart review of 761 patients with hand infections tracked by International Classification of Diseases, 9th Revision codes for finger or hand abscesses from 2001 to 2003 was performed at Parkland Memorial Hospital, Dallas, Texas. Culture results were obtained from 436 patients and analyzed for type of organism, and sensitivity profiles were obtained for all methicillin-resistant S. aureus isolates.
Results:
The median age of 761 patients was 40 years (range, 16 to 77 years); 71 percent were male and 28 percent were female. Of the 436 cultures reviewed, 371 (85 percent) had organisms identified. Methicillin-resistant S. aureus was the dominant single organism in hand infections cultured in all 3 years. The overall methicillin-resistant S. aureus rate was 61 percent of all hand infections in 2003. The percentage of S. aureus isolates identified as methicillin-resistant S. aureus increased from 55 percent to 78 percent over 3 years, up from 34 percent in 2001. Fortunately, 86 percent of these methicillin-resistant S. aureus isolates demonstrated sensitivity to conventional antibiotics, but a trend of resistance is developing.
Conclusions:
The incidence of community-acquired methicillin-resistant S. aureus increased from 34 percent to 61 percent over a 3-year period at the authors' county institution. An increasing trend of resistance patterns among conventional antibiotics was also demonstrated. As a result of this study, the treatment algorithm at Parkland Memorial Hospital has been modified to include abscess drainage accompanied by an antibiotic regimen targeted specifically at methicillin-resistant S. aureus. These data also have implications for broader application regarding simple skin infections and current antibiotic treatment algorithms.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) is increasingly common in hand infections, rising from 34% to 61% over three years. Treatment algorithms have been updated to target MRSA, though most isolates remain sensitive to conventional antibiotics.
Area of Science:
- Infectious Diseases
- Medical Microbiology
- Public Health
Background:
- Staphylococcus aureus is a leading cause of skin and soft-tissue infections.
- Prevalence of methicillin-resistant Staphylococcus aureus (MRSA), including community-acquired MRSA, has significantly increased in soft-tissue infections.
- Rates of MRSA approached 50% at the authors' institution in 2002, necessitating investigation into hand infections.
Purpose of the Study:
- To determine the incidence of MRSA in hand infections.
- To analyze the antibiotic resistance patterns of MRSA isolates from hand infections.
- To evaluate the implications for modifying antibiotic treatment algorithms for hand infections.
Main Methods:
- Retrospective chart review of 761 patients with hand infections (finger or hand abscesses) from 2001 to 2003.
- Analysis of culture results from 436 patients to identify organisms.
- Determination of sensitivity profiles for all identified MRSA isolates.
Main Results:
- MRSA was the dominant organism in cultured hand infections over the 3-year period.
- The overall MRSA rate in hand infections increased from 34% in 2001 to 61% in 2003.
- While 86% of MRSA isolates remained sensitive to conventional antibiotics, a developing resistance trend was observed.
Conclusions:
- The incidence of community-acquired MRSA in hand infections significantly increased over a 3-year period.
- An increasing trend of antibiotic resistance patterns among conventional antibiotics was noted.
- Treatment algorithms were modified to include MRSA-targeted antibiotic regimens, with implications for broader skin infection management.
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