A Prospective Investigation of Outcomes after Hospital Discharge for Endemic, Community-Acquired Methicillin-Resistant and -Susceptible Staphylococcus aureus …

LG Miller, C Quan, A Shay, K Mostafaie… - Clinical Infectious …, 2007 - academic.oup.com
LG Miller, C Quan, A Shay, K Mostafaie, K Bharadwa, N Tan, K Matayoshi, J Cronin, J Tan…
Clinical Infectious Diseases, 2007academic.oup.com
Background. Although community-acquired methicillin-resistant Staphylococcus aureus (CA-
MRSA) infection has become increasingly common, prospective data on outcomes of
patients with skin infection remain poorly defined. Methods. We prospectively observed a
cohort of 201 patients discharged after hospitalization for CA-MRSA infection or community-
acquired methicillin-susceptible S. aureus (CA-MSSA) infection. Patients were interviewed
30 and 120 days after they received a diagnosis. Our primary outcome was clinical …
Abstract
Background . Although community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infection has become increasingly common, prospective data on outcomes of patients with skin infection remain poorly defined.
Methods . We prospectively observed a cohort of 201 patients discharged after hospitalization for CA-MRSA infection or community-acquired methicillin-susceptible S. aureus (CA-MSSA) infection. Patients were interviewed 30 and 120 days after they received a diagnosis. Our primary outcome was clinical response, defined as no relapse, new S. aureus infection, or need for antibiotics at day 30.
Results . Among 117 patients with skin infection, the nonresponse rate at day 30 was similar among patients with CA-MRSA infection and those with CA-MSSA infection (23 [33%] of 70 vs. 13 [28%] of 47 patients; P = .55). Lack of incision and drainage was associated with nonresponse at day 30 (P = .005), but other clinical factors, including receipt of antibiotics inactive against the infecting strain, were not. Patients with CA-MSSA infection were more likely to be rehospitalized (P = .003) and to believe subjectively that they had not been cured (P = .002) at day 30. At day 30, there was a trend for close contacts of CA-MRSA—infected patients to develop a similar infection (13% vs. 4%; odds ratio, 3.3; 95% confidence interval, 0.7–15.8; P = .2).
Conclusion . Although it is believed patients with CA-MRSA skin infection may have more serious outcomes than those with CA-MSSA skin infection, we found similar outcomes in these 2 groups after hospital discharge. Clinical nonresponse at day 30 was associated with a lack of receipt of incision and drainage. Our data also suggest that close contacts of persons with CA-MRSA skin infection may have a higher likelihood of acquiring an infection.
Oxford University Press