Abstract/Details

Retrospective study of prevalence of Community Associated Methicillin Resistant Staphylococcus Aureus (CA-MRSA) seen in Texas MedClinics, San Antonio, TX from April 2006-August 2009


2010 2010

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Abstract (summary)

Purpose. To evaluate the presence of Community Associated–Methicillin Resistant Staphylococcus Aureus, CA-MRSA, in abscesses and skin and soft tissue infections presenting at 9 urgent care clinics in San Antonio, TX.

Methods. During the 40-month retrospective study (April 2006 to August 2009), wound cultures collected in 9 urgent care centers were evaluated for MRSA growth, antibiotics prescribed, follow up wound care, and antibiotic prescribing habits by physicians for all patients presenting with abscesses and skin/soft tissue infections.

Results. Across 9 urgent care centers in San Antonio, TX, 36,797 abscesses and cases of skin and soft tissue infections were treated during 40 months. Of the 36,797 cases, 9290 patients had wound cultures sent with 5,630 cultures sent to Texas MedClinic’s primary lab. Of the 5630 cultures sent to their primary lab, this reflected a prevalence of 4727 (84 %) cultures were positive for MRSA. Of the 9290 patients who had a wound culture sent (April 10th, 2006 to August 31st, 2009), a total of 4,307 antibiotics were prescribed. The top five antibiotics prescribed for CA-MRSA were Bactrim (55.5%), Clindamycin (18.4%), Bactroban (5%), Amoxicillin (3.5%), and Doxycycline (3%) representing 85.4% of the antibiotics prescribed. 8809/9290 (94.8%) of patients required no more than 3 follow up visits. Of the 33 physicians working full time during the entire study period, 29/33 (87.8%) of the physicians were family medicine physicians and represented varied prescribing rates of antibiotics between 11-76% with 26/33 (78.8%) of physicians prescribing antibiotics greater than 40% of the time.

Conclusions. Abscesses and soft tissue infections are a common presenting complaint to urgent care centers. This study reveals that antibiotic-prescribing practices can be improved with physician education since this high prevalence was not known previously. Also, treating abscesses with limited packing has been shown to be a viable option in this particular circumstance and would be open field for additional clinical research. Due to the high prevalence of CA-MRSA skin and soft tissue infections among patients presenting to urgent care centers presumptive treatment for MRSA is indicated. Increasing levels of resistance to penicillin antibiotics is concerning and warrants alternative antibiotic management strategies.

Indexing (details)


Subject
Public Health Education
Classification
0500: Public Health Education
Identifier / keyword
Health and environmental sciences, Abscesses, Antibiotics, CA-MRSA, Incision and drainage, Prevalence, Soft tissue infections, Texas
Title
Retrospective study of prevalence of Community Associated Methicillin Resistant Staphylococcus Aureus (CA-MRSA) seen in Texas MedClinics, San Antonio, TX from April 2006-August 2009
Author
Boyd, Linda Renee
Number of pages
46
Publication year
2010
Degree date
2010
School code
0219
Source
MAI 49/01M, Masters Abstracts International
Place of publication
Ann Arbor
Country of publication
United States
ISBN
9781124147802
Advisor
Herbold, John R.
Committee member
Urrutia-Rojas, Ximena
University/institution
The University of Texas School of Public Health
Department
Epidemiology & Disease Control
University location
United States -- Texas
Degree
M.P.H.
Source type
Dissertations & Theses
Language
English
Document type
Dissertation/Thesis
Dissertation/thesis number
1479576
ProQuest document ID
746816358
Copyright
Database copyright ProQuest LLC; ProQuest does not claim copyright in the individual underlying works.
Document URL
http://search.proquest.com/docview/746816358
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