Detection and initial management of complicated skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus.
BACKGROUND
Accurate diagnosis and initial management of skin and soft tissue infections (SSTIs) are essential to providing adequate care to patients. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the leading causes of SSTIs, and surgeons and other healthcare providers should assess these infections carefully to improve patient outcomes.


METHODS
Review of the pertinent literature and recommendations related to diagnosis and initial treatment with a focus on complicated SSTIs (cSSTIs).


RESULTS
Patients with SSTIs presenting to the hospital or outpatient setting need to be evaluated carefully. Clinical assessment of infection severity and underlying patient conditions is important. Purulence is a major feature of infections necessitating further assessment and intervention. Culturing and determination of antimicrobial susceptibility are essential. Incision and drainage, debridement, and administration of antimicrobial agents may be required. Immediate hospitalization and treatment with intravenous antibiotics are needed for more serious cases.


CONCLUSIONS
The growing prevalence of MRSA, particularly community-acquired MRSA in cSSTIs, and the increasing number of these infections observed in both the community and the hospital setting requires the immediate careful assessment of possible cSSTIs. Rapid, appropriate treatment is necessary to facilitate good patient care and outcomes. Antimicrobial therapy, surgical drainage/debridement, and close monitoring will be required, particularly in the management of cSSTIs resulting from infections with MRSA.
Surgical Trauma Intensive Care Unit, Department of Surgery, University of Virginia Health System, Charlottesville, VA 22908-0709, USA. rws2k@virginia.edu
Robert G
RG
Sawyer
D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D004322:Drainage; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D017410:Practice Guidelines as Topic; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000188:drug therapy; D013207:Staphylococcal Skin Infections / Q000175:diagnosis* / Q000188:drug therapy; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology