title: Recurrent skin and soft tissue infections due to methicillin-resistant Staphylococcus aureus requiring operative debridement.
abstract: BACKGROUND
  The aim of this study was to examine clinical factors associated with the recurrence of community-onset skin and soft tissue infections caused by methicillin-resistant Staphylococcus aureus.
  
  
  METHODS
  An observational case-comparison study based on a retrospective review of medical records was conducted in a public health system. All patients with community-onset skin and soft tissue infections caused by methicillin-resistant S aureus who underwent operative debridement from January 1999 to December 2003 were included. The outcome of interest was recurrence within 1 year.
  
  
  RESULTS
  Two hundred fifty-three patients met the criteria for inclusion. Fifty-three (21%) patients returned with recurrent episodes. These patients were compared with 200 patients (79%) who did not develop recurrence. On multivariate analysis, factors independently predictive of recurrence were medical history of abscess requiring surgical debridement within the previous year (adjusted odds ratio, 2.6; 95% confidence interval, 1.4-5.0; P = .002) and obesity (adjusted odds ratio, 3.4; 95% confidence interval, 1.4-8.8; P = .008).
  
  
  CONCLUSIONS
  Patients with obesity or histories of methicillin-resistant S aureus infection are at significantly increased risk for recurrent soft tissue infection.
authors.affiliation: Department of Medicine, University of Texas Southwestern Medical Center, Dallas, USA. pranavi.sreeramoju@utsouthwestern.edu
authors.forename: Pranavi
authors.initials: P
authors.lastname: Sreeramoju
authors.forename: Nabilla S
authors.initials: NS
authors.lastname: Porbandarwalla
authors.forename: Jorge
authors.initials: J
authors.lastname: Arango
authors.forename: Kerry
authors.initials: K
authors.lastname: Latham
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Dent
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Stewart
authors.forename: Jan E
authors.initials: JE
authors.lastname: Patterson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008499:Medical Records; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents