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

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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Current as of March 2011
Internet Citation: Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms. March 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/mrsa/iowa_mrsatabs12-14.html