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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Evolving Threat of Community Acquired Methicillin Resistant Staphylococcus aureus Upper Extremity Infections in the

Nandoun Abeysekera1, Stephen Wong1, Bryce Jackson1

  • 1* Auckland Regional Plastic, Reconstructive & Hand Surgery Unit, Auckland, New Zealand.

The Journal of Hand Surgery Asian-Pacific Volume
|May 1, 2019
PubMed

Insights

Community Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA) infections are rising globally. In our region, CA-MRSA rates in upper extremity infections increased, exceeding 15% in Maori and Pacific Island populations.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Microbiology

Background:

  • Community Acquired Methicillin Resistant Staphylococcus aureus (CA-MRSA) is a growing global health security threat.
  • Previous studies reported 7% CA-MRSA rates in upper extremity infections (2004-2009) at Auckland Regional Hand Unit, below CDC empiric treatment thresholds.
  • This study investigates current CA-MRSA prevalence and characteristics in upper extremity infections.

Purpose of the Study:

  • To determine the prevalence and characteristics of CA-MRSA in upper extremity infections.
  • To assess trends in CA-MRSA infection rates over a 5-year period.
  • To identify high-risk ethnic subpopulations requiring updated empiric treatment guidelines.

Main Methods:

  • A retrospective study of 1252 patients with upper extremity infections requiring operative management (2011-2015).
  • Data collected included ethnicity, cultured organisms, antibiotic sensitivities, infection rates, and treatment practices.
  • Analysis focused on identifying CA-MRSA prevalence and associated clinical factors.

Main Results:

  • 12% (150/1252) of patients had culture-positive CA-MRSA upper extremity infections.
  • An increasing annual trend of CA-MRSA was observed.
  • CA-MRSA rates exceeded 15% in Maori and Pacific Island ethnic subpopulations in 2014-2015.

Conclusions:

  • While overall CA-MRSA rates remain lower than international reports, regional trends are increasing.
  • Empiric treatment thresholds have been met in Maori and Pacific Island populations.
  • Increasing multi-drug resistant CA-MRSA necessitates evolving regional guidelines for empiric coverage.
Keywords:
Antimicrobial resistanceCommunity acquired MRSAHand InfectionsStaphylococcus aureus

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