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Increased oxacillin resistance in thigh pyomyositis in diabetic patients

C G Zalavras1, N Rigopoulos, L Poultsides

  • 1Department of Orthopaedics, LAC+USC Medical Center, University of Southern California, Keck School of Medicine, 1200 N. State St. GNH-3900, Los Angeles, CA 90033, USA. zalavras@usc.edu

Clinical Orthopaedics and Related Research
|March 11, 2008
PubMed
Abstract

Insights

Diabetic patients with thigh pyomyositis require broad-spectrum antibiotics. This study found increasing rates of oxacillin-resistant Staphylococcus aureus, necessitating coverage for this pathogen, alongside Gram-negative and anaerobic organisms.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Diabetology

Background:

  • Thigh abscesses from pyomyositis are infrequent in diabetic patients.
  • Guiding empiric antibiotic therapy is crucial for effective treatment.

Purpose of the Study:

  • To determine the prevalence of oxacillin-resistant Staphylococcus aureus (ORSA) and Gram-negative organisms in diabetic patients with thigh abscesses.
  • To assess the trend of ORSA infections over the study period.

Main Methods:

  • Retrospective review of 39 adult diabetic patients with deep thigh abscess.
  • Analysis of microbial cultures, including S. aureus, Gram-negative, and anaerobic organisms.
  • Evaluation of ORSA rates and their increase over time.

Main Results:

  • Staphylococcus aureus was the most common pathogen (82%).
  • Oxacillin-resistant S. aureus (ORSA) accounted for 25% of S. aureus infections.
  • ORSA infections significantly increased from 2004 to 2006.

Conclusions:

  • Empiric antibiotic therapy for diabetic thigh pyomyositis must cover ORSA.
  • Broad-spectrum coverage is essential, including Gram-negative and anaerobic bacteria.

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