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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
MRSA-related perianal abscesses: an underrecognized disease entity
Jeffrey B Albright1, Mark J Pidala, Joseph R Cali
1University of Texas Affiliated Hospitals, 6550 Fannin Street, Suite 2307, Houston, Texas 77030, USA. jb_albright@hotmail.com
Diseases of the Colon and Rectum
|May 26, 2007
Summary
Methicillin-resistant Staphylococcus aureus (MRSA) is common in perianal abscesses, affecting nearly 35% of cases. Clinical presentation alone cannot identify MRSA, suggesting routine culturing for extensive or purulent abscesses.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) perianal abscesses are underrecognized.
- Characteristics of MRSA versus non-MRSA perianal abscesses are not well-defined.
Purpose of the Study:
- To determine the prevalence of MRSA in perianal abscesses.
- To compare the clinical presentation and outcomes of MRSA-positive and MRSA-negative perianal abscesses.
Main Methods:
- Retrospective review of 104 patients with perianal abscesses undergoing incision and drainage (2003-2005).
- Collected data on demographics, abscess characteristics, MRSA presence on culture, antibiotic susceptibilities, and clinical course.
- Analyzed factors associated with MRSA positivity.
Main Results:
- MRSA was present in 34.8% of cultured perianal abscesses.
- MRSA-positive abscesses were associated with extensive induration, erythema, and minimal purulence (ORs 6.52, 5.75, 9.72 respectively).
- Ischiorectal abscesses were less likely to be MRSA-positive (OR 0.34). No MRSA-positive cases developed fistulas.
Conclusions:
- The prevalence of MRSA in perianal abscesses is higher than previously reported.
- Risk factors alone are insufficient for identifying MRSA perianal abscesses.
- Culturing perianal abscesses with extensive induration/erythema or minimal purulence may be beneficial due to unique MRSA antibiotic resistance patterns.
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