title: Non-suppurative cellulitis: risk factors and its association with Staphylococcus aureus colonization in an area of endemic community-associated methicillin-resistant S. aureus infections.
abstract: Suppurative methicillin-resistant Staphylococcus aureus (MRSA) skin infections are common and associated with MRSA colonization, but little is known about non-suppurative cellulitis and its relationship with MRSA colonization in areas endemic for community-associated MRSA. We prospectively enrolled patients hospitalized for non-suppurative cellulitis (n=50) and matched controls (n=100) and found S. aureus colonization was similar in cases and controls (30% vs. 25%, P=0·95). MRSA was uncommon in cases (6%) and controls (3%) (P=0·39). All MRSA isolates were USA300 by pulsed-field gel electrophoresis. Independent risk factors for non-suppurative cellulitis were diabetes (OR 3·5, 95% CI 1·4-8·9, P=0·01) and homelessness in the previous year (OR 6·4, 95% CI 1·9-20·9, P=0·002). These findings suggest that MRSA may only rarely be causative of non-suppurative cellulitis.
authors.affiliation: Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA. seells@labiomed.org
authors.forename: S J
authors.initials: SJ
authors.lastname: Eells
authors.forename: S
authors.initials: S
authors.lastname: Chira
authors.forename: C G
authors.initials: CG
authors.lastname: David
authors.forename: N
authors.initials: N
authors.lastname: Craft
authors.forename: L G
authors.initials: LG
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015373:Bacterial Typing Techniques; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D016022:Case-Control Studies; D002481:Cellulitis / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D048909:Diabetes Complications; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D008875:Middle Aged; D058889:Molecular Typing; D011446:Prospective Studies; D012307:Risk Factors; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult