Stratification of the risk factors of community-acquired methicillin-resistant Staphylococcus aureus hand infection.
OBJECTIVE
Several recent studies showed an increase in methicillin-resistant Staphylococcus aureus (MRSA) hand infections. The purpose of this study was to determine the prevalence of community-acquired MRSA hand infections in an urban setting and to determine independent risk factors for such infections.


METHODS
A retrospective chart review of patients with hand infections was performed from 2002 to 2009. Those with community-acquired hand infections who had surgical irrigation and debridement and intraoperative culture were entered into the study. Patient demographics-including age and gender; mechanism of injury; infection risk factors (diabetes, chronic hepatitis, intravenous intravenousdrug use, and immune-compromised conditions); place of residence/housing status; history of hospitalization, prior antibiotics use and surgery; and culture results, erythrocyte sedimentation rate, C-reactive protein, and white blood cell count-were extracted from the medical records. Regression analyses were performed to identify significant risk factors for MRSA infection.


RESULTS
A total of 102 patients met our inclusion criteria. The MRSA organism was identified in 32 patients. In the analysis of all the potential risk factors, only intravenous drug use showed significant correlation with MRSA infection.


CONCLUSIONS
In our patients, only intravenous drug use correlated with community-acquired MRSA hand infections. Patient education about intravenous drug use and empiric treatment with MRSA-appropriate antibiotics for intravenous drug users presenting with hand infections are recommended.


METHODS
Prognostic IV.
Nourbakhsh
Ali
A
Department of Orthopedics, University of Medicine and Dentistry, New Jersey Medical School, Newark, NJ 07103, USA.
Papafragkou
Sotirios
S
Dever
Lisa L
LL
Capo
John
J
Tan
Virak
V
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006225:Hand / Q000382:microbiology*; D006505:Hepatitis / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population; D055815:Young Adult