Acute rise in methicillin-resistant Staphylococcus aureus infections in a coastal community.
OBJECTIVE
Describe the incidence of head and neck community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections over a 5-year period at a coastal tertiary medical center.


METHODS
Retrospective chart review.


METHODS
All patients presenting to the otolaryngology service with cultures taken from head and neck infections between 1999 and 2004 were eligible for inclusion. Statistical analysis was used to determine significance of the changing incidence of isolated organisms over the study period.


RESULTS
CA-MRSA infections rose from 21% to 64% over the 5-year period. The increasing trend in CA-MRSA infections reached statistical significance from 2003 to 2004. All CA-MRSA isolates were resistant to cefazolin and penicillin, but most were sensitive to clindamycin.


CONCLUSIONS
Our data demonstrates a striking increase in the incidence of CA-MRSA. We have tailored our treatment of cutaneous head and neck infections to include empiric treatment for CA-MRSA using clindamycin. Awareness and monitoring of this trend will be important for all practitioners involved in the care of these patients.
Tripler Army Medical Center, Tripler, HI, USA. nici.eddy.bothwell@us.army.mil
Nici Eddy
NE
Bothwell
Joseph
J
Shvidler
Benjamin B
BB
Cable
D000038:Abscess / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D002437:Cefazolin / Q000627:therapeutic use; D018550:Cephalosporin Resistance; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology*; D004427:Ear Diseases / Q000453:epidemiology / Q000382:microbiology; D005148:Facial Dermatoses / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009333:Neck / Q000382:microbiology; D009668:Nose Diseases / Q000453:epidemiology / Q000382:microbiology; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects
D002437:Cefazolin