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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess, Ten-Year Experience at a Tertiary
Bryan Walker1, Eric Heidel1, Mahmoud Shorman1
1University of Tennessee, Graduate School of Medicine.
Background:
Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU).
Methods:
This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA.
Results:
Twenty-one patients were included. Average age was 46 years. Fourteen (67%) presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections in 52%, history of genitourinary disease or instrumentation in 48%, IDU in 38%, and diabetes mellitus in 38%. Methicillin-resistant staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up.
Conclusions:
S. aureus prostate abscess (PA) continues to be a rare complication of S.aureus infections. MRSA is the culprit in most published reports. In high risk patients with persistent bacteremia physicians need to consider the prostate as a site of infection.
Insights
Staphylococcus aureus (S. aureus) prostate abscess (PA) is rare but increasingly reported, especially with injection drug use (IDU). Methicillin-resistant S. aureus (MRSA) is often involved, necessitating consideration of the prostate in high-risk patients with bacteremia.
Area of Science:
- Infectious Diseases
- Urology
- Microbiology
Background:
- Prostatic abscess (PA) is typically caused by Enterobacteriaceae, but Staphylococcus aureus (S. aureus) PA is emerging.
- Increased reports of S. aureus PA correlate with rising rates of bacteremia linked to injection drug use (IDU).
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of S. aureus prostatic abscesses.
- To identify risk factors and treatment patterns for S. aureus PA.
Main Methods:
- Retrospective review of adult patients diagnosed with S. aureus PA between 2008 and 2018.
- Analysis of patient demographics, risk factors, causative pathogens, treatment, and clinical outcomes.
Main Results:
- Twenty-one patients (average age 46) were included, with 67% presenting genitourinary symptoms.
- Key risk factors included concurrent skin/soft tissue infections (52%), genitourinary issues (48%), IDU (38%), and diabetes (38%).
- Methicillin-resistant S. aureus (MRSA) was identified in 57%, and 81% had concurrent bacteremia. Drainage and antibiotics (3-8 weeks) were common; 81% of follow-up patients achieved clinical resolution.
Conclusions:
- S. aureus PA remains a rare but significant complication of S. aureus infections, with MRSA being the predominant pathogen.
- Physicians should consider the prostate as a potential infection site in high-risk patients presenting with persistent bacteremia.
- Early diagnosis and appropriate management, including drainage and antibiotics, are crucial for favorable outcomes.
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