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Risk factors associated with clindamycin-resistant, methicillin-resistant Staphylococcus aureus in hand abscesses.

AbstractPURPOSE:
To identify risk factors for clindamycin resistance in acute hand abscesses caused by methicillin-resistant Staphylococcus aureus (MRSA).
METHODS:
We performed a retrospective review of 247 consecutive culture-positive hand abscesses from 2010 to 2012 at an urban hospital. Historical and laboratory data from patients with abscesses that grew MRSA with and without clindamycin resistance were compared in a multivariate analysis.
RESULTS:
Methicillin-resistant Staphylococcus aureus grew on culture from 103 abscesses; 16% of those isolates were resistant to clindamycin. Multivariate analysis showed that younger age, intravenous drug use, and nosocomial acquired MRSA were significant risk factors for concurrent clindamycin resistance. Patients with a history of intravenous drug use and nosocomial acquired MRSA were, respectively, 11 and 5 times more likely to have concurrent clindamycin resistance. History of MRSA infection and human immunodeficiency virus were not identified as risk factors.
CONCLUSIONS:
Patients with a history of intravenous drug use or recent contact with health care facilities appear to be a potential reservoir for emerging multidrug-resistant MRSA. Selection of clindamycin as an empiric antibiotic should be especially avoided for these groups.
TYPE OF STUDY/LEVEL OF EVIDENCE:
Prognostic III.
AuthorsRick Tosti, Arianna Trionfo, John Gaughan, Asif M Ilyas
JournalThe Journal of hand surgery (J Hand Surg Am) Vol. 40 Issue 4 Pg. 673-6 (Apr 2015) ISSN: 1531-6564 [Electronic] United States
PMID25707549 (Publication Type: Journal Article)
CopyrightCopyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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