An investigation of antibiotic susceptibility to empiric therapy for community-associated methicillin-resistant Staphylococcus aureus

To analyze antibiotic susceptibility patterns of community-associated methicillin-resistant Staphylococcus aureus (MRSA) isolates obtained from skin and soft tissue infections among Wisconsin outpatients. Retrospective genotype testing. Isolates were forwarded to the Wisconsin State Laboratory of Hy...

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Published in:	Wisconsin medical journal (Madison, Wis.) Vol. 113; no. 2; pp. 59 - 63
Main Authors:	Harless, Kami, Borlaug, Gwen, Monson, Timothy A, Stemper, Mary E, Davis, Jeffrey P, Abing, Ann E, Shelerud, Jared F
Format:	Journal Article
Language:	English
Published:	United States 01-04-2014
Subjects:	Anti-Bacterial Agents - pharmacology Community-Acquired Infections - drug therapy Community-Acquired Infections - epidemiology Community-Acquired Infections - microbiology Drug Resistance, Bacterial Female Genotype Humans Male Methicillin-Resistant Staphylococcus aureus - genetics Methicillin-Resistant Staphylococcus aureus - isolation & purification Microbial Sensitivity Tests Retrospective Studies Staphylococcal Infections - drug therapy Staphylococcal Infections - epidemiology Staphylococcal Infections - microbiology Staphylococcus aureus Wisconsin - epidemiology Wisconsin
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Summary:	To analyze antibiotic susceptibility patterns of community-associated methicillin-resistant Staphylococcus aureus (MRSA) isolates obtained from skin and soft tissue infections among Wisconsin outpatients. Retrospective genotype testing. Isolates were forwarded to the Wisconsin State Laboratory of Hygiene and Marshfield Labs from clinical laboratories throughout Wisconsin. MRSA isolates submitted during April, 2010-February, 2012 underwent genotype analysis using pulsed-field gel electrophoresis. Antibiotic susceptibility patterns were determined for all isolates identified by electrophoresis subtyping as strain type USA300, and pattern comparisons were made by public health region. Among 835 MRSA isolates submitted, 217 (26%) were genotyped. Of these, 152 (70%) were USA300 MRSA. Among the 152 USA300 isolates, 95% were susceptible to clindamycin and 99% were susceptible to tetracycline and trimethoprim-sulfamethoxazole. The proportion of clindamycin-susceptible isolates from the southern region was significantly lower when compared to the other 4 regions combined (P = 0.03). One southern region clindamycin-resistant isolate was also resistant to trimethoprim-sulfamethoxazole. USA300 MRSA was the predominant strain isolated from outpatient skin and soft tissue sites. Antibiotic susceptibility patterns among Wisconsin USA300 MRSA isolates are similar to patterns found in national studies. Local providers should continue to follow national practice guidelines for treatment of outpatient skin infections. A cluster of 4 clindamycin-resistant isolates and 1 trimethoprim-sulfamethoxazole resistant isolate was detected in the southern region, warranting continued surveillance for antibiotic resistance among community-associated MRSA isolates.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	1098-1861