Staphylococcus aureus prevalence and antimicrobial susceptibility in isolates from skin and soft tissue infections in outpatients

Keywords: Staphylococcus aureus - Soft tissues infections - Outpatients - Argentina

Abstract

Background: Skin and soft tissues infections (SSTIs) are the third cause of medical consultation in our hospital. S.aureus is the most frequent etiologic agent isolated in SSTIs and methicillin-resistant is the most important resistance mechanism. Our objective was to analyze the prevalence of etiologic agents causing SSTIs in outpatients and to study its antimicrobial susceptibility.

Methods:Descriptive and retrospective study that included all outpatient SSTIs samples from October 2017 to April 2022.

Results: We obtained 180 positive cultures of samples from SSTIs during the study period, 12 were polymicrobial infections. Of a total of 307 isolates: the most frequently isolated microorganism was S.aureus (111; 36.2%). We found 71 SAMR (64%) and 40 SAMS (36%). Of the MRSA, 67 (95%) were community (SAMRC) due to microbiological criteria, and 4 hospital MRSA (5%). Of the SAMRC strains, 44 (66%) had no accompanying resistance, 15 (22%) were resistant to erythromycin, 12 (18%) to gentamicin, and 7 (10%) to clindamycin.

Conclusions: The most frequently isolated microorganism in SSTIs was S.aureus and 67 isolates were categorized as SAMRC, therefore it is necessary to consider SAMRC as a frequent pathogen. Due to the low resistance found for CLI and TMS, they should be considered for empirical treatment in SSTIs in outpatients.

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Author Biographies

Carlos Tubaro

Bioquímico especialista en bioquímica clínica. Unidad de microbiología. H.I.G.A. "Prof. Dr. Luis Güemes"

Ruben Dominguez

Técnico de laboratorio. Unidad de microbiología. H.I.G.A. "Prof. Dr. Luis Güemes"

Mercedes Hinojosa

Técnico de laboratorio. Unidad de microbiología. H.I.G.A. "Prof. Dr. Luis Güemes"

Sandra Mosca

Bioquímica. Jefa de laboratorio central. H.I.G.A. "Prof. Dr. Luis Güemes"

Giannina De Leo

Bioquímica especialista en microbiología clínica. Unidad de microbiología. H.I.G.A. "Prof. Dr. Luis Güemes"

References

1- Cunto E, Colque A, Herrera M, Chediack V, Staneloni M, Saúl P. Infecciones graves de piel y partes blandas. Puesta al día. Medicina (Buenos Aires) 2020; 80(5), 531-540
2- Sociedad Española de Medicina Interna. Protocolo de enfermedades infecciosas. Capítulo 5: Infecciones de piel y partes blandas. 2009. https://www.fesemi.org/sites/default/files/documentos/publicaciones/capitulo-5_5.pdf
3- Fung HB, Chang JY, Kuczynski S. A practical guide to the treatment of complicated skin and soft tissue infections. Drugs. 2003;63(14):1459-80
4- Consenso SADI-SAM-SAD-CACCVE. Guía para el manejo racional de las infecciones de piel y partes blandas. Rev Panam Infectol 2009;11(3):49-65.
5- Grundmann H, Aires-de-Sousa M, Boyce J, Tiemersma E. Emergence and resurgence of methicillin-resistant Staphylococcus aureus as a public-health threat, Lancet, 2006, vol. 368 (pg. 874-85)
6- Daum RS. Clinical practice. Skin and soft-tissue infections caused by methicillin-resistant Staphylococcus aureus. N Engl J Med 2007;357(4):380-90.
7- Deresinski S. Methicillin-resistant Staphylococcus aureus: an evolutionary, epidemiologic, and therapeutic odyssey. Clin Infect Dis 2005;40(4):562-73.
8- Palombarini N, Gardella N, Tudini S et al. Infecciones adquiridas en la comunidad por Staphylococcus aureus resistente a meticilina en un Hospital de agudos. Rev Arg de Microbiología 2007;39:151-5.
9- Stryjewski ME, Chambers HF. Skin and soft-tissue infections caused by community-acquired methicillin-resistant Staphylococcus aureus. Clin Infect Dis 2008;46 Suppl 5:S368-77.
10- CLSI. Performance Standards for Antimicrobial Susceptibility Testing. 32th ed. CLSI supplement M100.Wayne, PA: Clinical and Laboratory Standards Institute; 2022.
11- Egea A, Gagetti P, Lamberghini R, Faccone D, Lucero C, Vindel A, Tosoroni D, Garnero A, Saka H, Galas M, Bocco J, Corso A, Sola C. New patterns of methicillin-resistant Staphylococcus aureus (MRSA) clones, community-associated MRSA genotypes behave like healthcare-associated MRSA genotypes within hospitals. International Journal of Medical Microbiology 2014; 304, Issue 8:1086-1099
12- Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC; Infectious Diseases Society of America. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.
13- Miller LG, Daum RS, Creech CB, et al. Clindamycin versus trimethoprim–sulfamethoxazole for uncomplicated skin infections. N Engl J Med 2015; 372:1093-103.
14- Filippin L, Roisin S, Nonhoff C, Vandendriessche S, Heinrichs A, Denis O. Evaluation of the automated Vitek 2 system for detection of various mechanisms of macrolide and lincosamide resistance in Staphylococcus aureus. J Clin Microbiol. 2014 Nov;52(11):4087-9.
15- Panagea S, Perry JD, Gould FK. Should clindamycin be used as treatment of patients with infections caused by erythromycin-resistant staphylococci? J Antimicrob Chemother. 1999 Oct;44(4):581-2.
16- Anodal M, Villani M, Rodríguez L, Schijman M, Terzano M, Gardella N, Mollerach M, Merola G. Infecciones de piel y partes blandas por Staphylococcus aureus meticilino resistente de la comunidad. Análisis molecular y genético. Dermatol Argent. 2012;18:213-20.
Published
2024-04-07
How to Cite
Cabrera, R. R., Tubaro, C., Dominguez, R., Hinojosa, M., Mosca, S., & De Leo, G. (2024). Staphylococcus aureus prevalence and antimicrobial susceptibility in isolates from skin and soft tissue infections in outpatients. Actualizaciones En Sida E Infectología, 32(114). https://doi.org/10.52226/revista.v32i114.186
Section
Original article