[Methi-resistant Staphylococcus aureus in dermatological practice: origin, risk factors and outcome].
BACKGROUND
Increased frequency of methiresistant Staphylococcus aureus (MRSA) in inpatients is a day to day problem.


OBJECTIVE
To determine the origin of MRSA, the causes for contamination, and potential complications in a department of Dermatology.


METHODS
A retrospective study of patients hospitalized in a dermatology department with cutaneous MRSA during 1997-1998. We considered age, type and duration of dermatitis, geographic origin of patients on admission, previous hospitalizations, time between arrival in the ward and positive MRSA, and complications requiring systemic antibiotics.


RESULTS
Out of 4579 of our patients, 53 (0.011 p. 100) had positive MRSA. They were on average 70.86 years-old (26 to 97). The most common underlying dermatitis was leg ulcers (30) and foot sores (4). Dermatitis had lasted for more than 1 month in 48 patients. Most of the patients (40) had their MRSA on admission to our ward. Twenty six patients admitted from home had MRSA; only 9 had never been in an hospital. Six patients had diabetes mellitus. Thirty two patients healed with local treatment for their dermatitis. Thirteen patients have had some complications (erysipela 1, osteoarthritis 3, septicemia 2, febrile syndrome 9).


CONCLUSIONS
Most patients with MRSA had leg ulcers or foot sores, confirming liability of chronic wounds to MRSA colonizing. Thirty one out of 40 patients with MRSA at arrival had been previously hospitalized. Hospitalization increases the risk of MRSA contamination. Treatment of MRSA is essentially that of the underlying dermatitis. However, it is still necessary to monitor the lesion for complications.
Trividic
M
M
Service de Dermatologie, CHU Dupuytren Limoges, France.
Gauthier
M L
ML
Sparsa
A
A
Ploy
M C
MC
Mounier
M
M
Boulinguez
S
S
Bedane
C
C
Bonnetblanc
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010343:Patient Admission; D012307:Risk Factors; D013207:Staphylococcal Skin Infections / Q000188:drug therapy* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D014946:Wound Infection / Q000188:drug therapy / Q000382:microbiology
D000900:Anti-Bacterial Agents
Staphylococcus aureus métirésistant en dermatologie.