Staphylococcus aureus and other skin and soft tissue infections among basic military trainees, Lackland Air Force...

Military training environments have been identified as high-risk settings for acquisition of skin and soft tissue infections (SSTIs), including those caused by methicillin-resistant Staphylococcus aureus (MRSA). Among the 148,355 basic military trainees at Lackland Air Force Base, Texas, between 1 October 2008 and 30 September 2012, there were 289 SSTIs, including 48 cases of culture-confirmed MRSA and 48 cases of possible MRSA-defined as SSTIs treated with both incision and drainage and MRSA drug coverage (i.e., trimethoprim-sulfamethoxazole, clindamycin, a tetracycline, or linezolid). The period prevalence rates of all SSTIs and MRSA SSTIs increased annually since fiscal year 2010. Of the 87 SSTIs cultured during the surveillance period, 74 were positive: MRSA (n=48); methicillin-sensitive Staphylococcus aureus (n=24); Haemophilus parainfluenzae (n=1); and viridans Streptococcus (n=1). Among MRSA positive cultures, three were resistant to clindamycin, one to tetracycline, and one to both clindamycin and tetracycline; none was resistant to trimethoprim-sulfamethoxazole. An algorithmic clinical approach and heightened public health measures may reduce rates of future SSTIs among basic trainees at Lackland Air Force Base.