Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms

Tables 12-14

Table 12. Skin infection type, treatment characteristics, and whether MRSA cultured for prospective patients

Clinic

No. Useable Skin
and Soft Tissue Infection Prospective Forms
n (%)

Abscess
Only
n (%)

Cellulitis
Only
n (%)

Both Abscess & Cellulitis
n (%)

Incision and Drainage Done
n (%)

Culture Sent
n (%)

Antibiotic Prescribed at Initial Visit
n (%)

MRSA Positive
n (%)

1

8

1 (14)

4 (57)

2 (29)

2 (25)

2 (25%)

8 (100)

0

2

0

0

0

0

0

0

0

0

3

23

2 (9)

20 (87)

1 (4)

3 (13)

12 (52)

21 (91)

4 (33)

4

9

2 (22)

4 (44)

3 (33)

5 (56)

6 (67)

9 (100)

4 (67)

5

11

3 (30)

3 (30)

4 (40)

5 (46)

7 (64)

11 (100)

3 (43)

6

0

0

0

0

0

0

0

0

7

5

1 (25)

3 (75)

0

1 (20)

2 (40)

5 (100)

1 (50)

8

10

1 (10)

6 (60)

0

2 (20)

5 (50)

9 (90)

0

9

30

5 (17)

17 (57)

8 (27)

5 (17)

6 (20)

30 (100)

1 (17)

10

18

3 (17)

9 (50)

6 (33)

9 (50)

10 (56)

18 (100)

2 (20)

Total

114

18 (17)

66 (61)

24 (22)

32 (28)

49 (43)

111 (97)

15

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Table 13. Comparison of retrospective and prospective data, all cases

 

Retrospective
N = 263
N (%)

Prospective
N = 114
N (%)

P-Value

Demographics

Gender
  Female
  Male

131 (50)
132 (50)

66 (58)
48 (42)

0.149

Age groups
   < 20
   20 to < 40
   40 to < 65
   65 to 96

27 (24)
34 (30)
38 (34)
14 (12)

60 (23)
66 (25)
88 (34)
48 (18)

0.489

Age group (years)
   < 40
   ≥ 40

126 (48)
136 (52)

61 (54)
52 (46)

0.295

Rurality
   Non-rural
   Rural

183 (70)
80 (30)

82 (73)
31 (27)

0.561

Insurance
   Private
   Medicaid
   Medicare
   Uninsured

152 (59)
44 (17)
44 (17)
18 (7)

76 (70)
20 (19)
10 (9)
2 (2)

0.037

Race
   Caucasian
   Non-Caucasian

191 (96)
8 (4)

107 (94)
7 (6)

0.398

Ethnicity
   Hispanic
   Non-Hispanic

10 (5)
178 (95)

2 (2)
112 (98)

0.124

Patient Presenting Characteristics

Site of Infection
   Face/neck
   Groin/pubic/lower extremities
   Thorax/upper extremities

34 (13)
122 (47)
104 (40)

15 (14)
47 (44)
45 (42)

0.871

Initial temperature (°F)
   < 99°
   ≥ 99°

206 (90)
24 (10)

101 (91)
10 (9)

0.681

Duration of infection prior to being seen
   < 5 days
   ≥ 5 days

132 (60)
89 (40)

65 (61)
41 (39)

0.783

Patient hospitalized with infection
   Yes
   No

11 (4)
252 (96)

3 (3)
109 (97)

0.482

Patient had at least 1 risk factor for MRSA
   Yes
   No

69 (26)
194 (74)

39 (34)
75 (66)

0.116

Patient had diabetes
   Yes
   No

35 (13)
228 (87)

19 (17)
95 (83)

0.393

Wound Type
   Abscess only
   Cellulitis only
   Abscess and cellulitis

93 (36)
143 (54)
27 (10)

18 (17)
66 (61)
24 (22)

 < 0.001

Treatment

Incision and drainage done
   Yes
   No

85 (32)
178 (67)

32 (28)
82 (72)

0.413

Culture done
   Yes
   No

92 (44)
171(65)

50 (35)
64 (56)

0.102

Wound packed
   Wound packed
   Wound not packed
   Incision and drainage not done

30 (11)
55 (21)
178 (68)

8 (7)
22 (20)
82 (73)

0.403

Only for those ( n = 115) who had an incision and drainage done
   Wound packed
   Wound not packed

30 (35)
55 (65)

8 (27)
22 (73)

0.388

MRSA cultured
   Yes
   No

45 (49)
47 (51)

15 (30)
35 (70)

0.029

Antibiotics Prescribed

Antibiotic prescribed at initial visit
   Yes
   No

246 (93)
17 (7)

111 (97)
3 (3)

0.127

Antibiotic(s) at initial visit covered MRSA
   Yes
   No

70 (29)
176 (71)

58 (51)
56 (49)

< 0.001

Antibiotics were prescribed that covered MRSA at some time during infection
   Yes
   No

91 (37)
157 (63)

68 (60)
46 (40)

< 0.001

Total number of antibiotics used over the course of the infection
   ≤ 2
   > 2

241 (92)
22 (8)

103 (90)
11 (10)

0.685

Total number of antibiotics used over course of infection
   0
   1
   2
   3
   4
   5
   6

15 (6)
176 (67)
50 (19)
16 (6)
3 (1)
3 (1)
0

1 (1)
77 (67)
25 (22)
8 (7)
2 (2)
0
1 (1)

0.194

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Table 14. Comparison of retrospective and prospective treatments for any infection that had an abscess
N=162

 

Retrospective
Abscess Only and
Abscess & Cellulitis
N = 120

Prospective
Abscess Only and
Abscess and Cellulitis
N = 42

P-Value

Incision and drainage done
   Yes
   No

83 (69)
37 (31)

24 (57)
18 (43)

0.157

Culture done
   Yes
   No

58 (48)
62 (52)

26 (62)
16 (38)

0.130

Antibiotic prescribed at first visit
   Yes
   No

108 (90)
12 (10)

41 (98)
1 (2)

0.118

Initial antibiotics covered MRSA
   Yes
   No

46 (43)
62 (57)

28 (67)
14 (33)

0.008

Antibiotics covered MRSA at some time during infection
   Yes
   No

56 (51)
53 (49)

28 (67)
14 (33)

0.090

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Page last reviewed October 2014
Internet Citation: Tables 12-14. October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/mrsa/iowa_mrsatabs12-14.html