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Nearly 75% of S. aureus infections in hands test positive for MRSA

Researchers found more cases of community-acquired MRSA in urban hospitals than previously reported.

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As researchers scramble to develop methicillin-resistant Staphylococcus aureus antibiotics, a new study shows a higher infection rate for hand patients treated at urban centers.

In a study of 52 patients treated at Chicago-area hospitals, researchers discovered that 45 patients had staphylococcus aureus. Of these, 38 patients tested positive for community-acquired Methicillin-Resistant Staphylococcus aureus (MRSA). “So the incidence that we find is 73%, which is higher than what was previously documented in the literature,� Harold G. Bach, MD, an orthopedist with the University of Illinois, said during his presentation at the American Academy of Orthopaedic Surgeons 73rd Annual Meeting.

The researchers examined 61 patients with hand infections that were admitted to hospitals over nine months. Investigators defined community-related infections as contaminations that were present or incubated during admission. “They are not caused by an organism that was from a previous hospitalization or nursing home admission in the past year,� Bach said. Five patients proved ineligible for the study due to human “fight bites� and four patients had dialysis procedures.

The final cohort included 52 patients (48 men) with an average age of 41.2 years. In this group, 45 patients tested positive for staphylococcus aureus. “MRSA was identified in 73% of these and the absence of staph [was] 13%,� Bach said.

Previous studies

The research revealed more MRSA cases than previous studies. Bach cited research conducted by Young et al on 837 cultures collected from soft tissue infections, which revealed an 83% S. aureus rate. “Of those cultures, 63% were MRSA positive,� he said. Another study by Groom et al also showed that 55% of S. aureus cases tested positive for MRSA.

The new study highlights the need for new prophylaxis protocols. “This should be seriously taken into account when managing seemingly routine hand infections given that the treatment options are quite unique for MRSA infections,� Bach and colleagues wrote in their abstract.

Bach also questioned the effect of introducing new MRSA antibiotics. “What would be the most efficacious prepared antibiotic?,� he said. “If we begin treating patients very early with these other antibiotics, will we create new breeds of staph which are more dangerous?�

For more information:

• Bach HG, Steffin B, Chhadia A, et al. High prevalence of community acquired MRSA infections in an urban setting. #464. Presented at the American Academy of Orthopaedic Surgeons 73rd Annual Meeting. March 22-26, 2006. Chicago.
• Groom AV, Wolsey DH, Naimi TS, et al. Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. JAMA. 2001;268:1201-1205.
• Young DM, Harris HW, Charlbois ED, et al. An epidemic of methicillin-resistant Staphylococcus aureus soft tissue infections among medically underserved patients. Arch Surg. 2004;139:947-951.