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Community-acquired methicillin-resistant Staphylococcus aureus infections of the hand: prevalence and timeliness of treatment.
J Hand Surg Am 2009; 34(3):504-8JH

Abstract

PURPOSE

The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (ca-MRSA) appears to be increasing, but the timeliness of appropriate antibiotic delivery is often delayed. We retrospectively reviewed the prevalence of ca-MRSA infections in an urban setting, time from presentation to the hospital to appropriate antibiotic delivery, and differences in length of stay between the ca-MRSA and non-MRSA hand infections.

METHODS

We retrospectively reviewed all visits for hand infection cases to the emergency room of an urban academic medical center over a 12-month period. A formal hand infection algorithm was used in the treatment of each patient. All patients with culture-positive hand infections were included for evaluation. Infections determined to be nosocomial or not community-acquired were excluded. Patient demographics, laboratory studies, culture results, antibiotic delivery, and length of stay data were collected.

RESULTS

A total of 85 patients (55 male) with an average age of 39 years met the inclusion criteria. The overall prevalence rate of ca-MRSA hand infections was 55%. The average time to appropriate antibiotic delivery for ca-MRSA infection was 12 hours, versus 2.64 hours for non-MRSA hand infections (p > .5). The average length of stay was 4.0 days for ca-MRSA infections and 3.5 days for non-MRSA infections (p > .05). Univariate and multivariate analysis identified intravenous drug abuse and a serum white blood cell count of >8.7 as independent risk factors for ca-MRSA hand infections.

CONCLUSIONS

Community-acquired methicillin-resistant S. aureus infections of the hand continue to increase in urban settings. With the use of a formal hand infection treatment algorithm, we did not identify a statistical difference in appropriate antibiotic delivery time and length of stay between ca-MRSA and non-MRSA hand infections.

Authors+Show Affiliations

Temple Hand Center, Department of Orthopaedic Surgery, Temple University Hospital, Philadelphia, PA 19422, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19258149

Citation

O'Malley, Michael, et al. "Community-acquired Methicillin-resistant Staphylococcus Aureus Infections of the Hand: Prevalence and Timeliness of Treatment." The Journal of Hand Surgery, vol. 34, no. 3, 2009, pp. 504-8.
O'Malley M, Fowler J, Ilyas AM. Community-acquired methicillin-resistant Staphylococcus aureus infections of the hand: prevalence and timeliness of treatment. J Hand Surg Am. 2009;34(3):504-8.
O'Malley, M., Fowler, J., & Ilyas, A. M. (2009). Community-acquired methicillin-resistant Staphylococcus aureus infections of the hand: prevalence and timeliness of treatment. The Journal of Hand Surgery, 34(3), pp. 504-8. doi:10.1016/j.jhsa.2008.11.021.
O'Malley M, Fowler J, Ilyas AM. Community-acquired Methicillin-resistant Staphylococcus Aureus Infections of the Hand: Prevalence and Timeliness of Treatment. J Hand Surg Am. 2009;34(3):504-8. PubMed PMID: 19258149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community-acquired methicillin-resistant Staphylococcus aureus infections of the hand: prevalence and timeliness of treatment. AU - O'Malley,Michael, AU - Fowler,John, AU - Ilyas,Asif M, PY - 2008/05/30/received PY - 2008/11/16/revised PY - 2008/11/19/accepted PY - 2009/3/5/entrez PY - 2009/3/5/pubmed PY - 2009/6/19/medline SP - 504 EP - 8 JF - The Journal of hand surgery JO - J Hand Surg Am VL - 34 IS - 3 N2 - PURPOSE: The prevalence of community-acquired methicillin-resistant Staphylococcus aureus (ca-MRSA) appears to be increasing, but the timeliness of appropriate antibiotic delivery is often delayed. We retrospectively reviewed the prevalence of ca-MRSA infections in an urban setting, time from presentation to the hospital to appropriate antibiotic delivery, and differences in length of stay between the ca-MRSA and non-MRSA hand infections. METHODS: We retrospectively reviewed all visits for hand infection cases to the emergency room of an urban academic medical center over a 12-month period. A formal hand infection algorithm was used in the treatment of each patient. All patients with culture-positive hand infections were included for evaluation. Infections determined to be nosocomial or not community-acquired were excluded. Patient demographics, laboratory studies, culture results, antibiotic delivery, and length of stay data were collected. RESULTS: A total of 85 patients (55 male) with an average age of 39 years met the inclusion criteria. The overall prevalence rate of ca-MRSA hand infections was 55%. The average time to appropriate antibiotic delivery for ca-MRSA infection was 12 hours, versus 2.64 hours for non-MRSA hand infections (p > .5). The average length of stay was 4.0 days for ca-MRSA infections and 3.5 days for non-MRSA infections (p > .05). Univariate and multivariate analysis identified intravenous drug abuse and a serum white blood cell count of >8.7 as independent risk factors for ca-MRSA hand infections. CONCLUSIONS: Community-acquired methicillin-resistant S. aureus infections of the hand continue to increase in urban settings. With the use of a formal hand infection treatment algorithm, we did not identify a statistical difference in appropriate antibiotic delivery time and length of stay between ca-MRSA and non-MRSA hand infections. SN - 1531-6564 UR - https://www.unboundmedicine.com/medline/citation/19258149/Community_acquired_methicillin_resistant_Staphylococcus_aureus_infections_of_the_hand:_prevalence_and_timeliness_of_treatment_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0363-5023(08)01016-2 DB - PRIME DP - Unbound Medicine ER -