Purpose
An increase in the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections has been observed. The purpose of this study is to determine
the change in proportion of surgically treated CA-MRSA hand infections over the last
decade and to identify associated risk factors.
Methods
A retrospective review was performed of all 159 hand infections treated in the operating
room over an 11-year period (1997–2007). Mean age overall was 40 years, mean inpatient
length of stay was 4.9 days, and 115 of the 159 patients were male. Examined data
included known risk factors for MRSA, including human immunodeficiency virus infection,
diabetes mellitus, intravenous drug use, incarceration, and homelessness.
Results
Forty-eight patients had surgery for hand infections due to CA-MRSA. The yearly proportion
of CA-MRSA increased over the study period, and the risk of having an MRSA infection
was 41% higher with each progressive calendar year during the study period relative
to the apparent incidence of non-MRSA hand infections. Other factors associated with
CA-MRSA were intravenous drug use, felon-type infection, and prior hand infection.
Multivariable logistic regression identified intravenous drug use as a significant,
independent risk factor for CA-MRSA hand infection.
Conclusions
The proportion of surgically treated hand infections due to CA-MRSA has increased
during the last decade. Intravenous drug use was the only independent risk factor
for CA-MRSA infections treated in the operating room at our institution.
Key words
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Article info
Publication history
Published online: December 07, 2009
Accepted:
September 3,
2009
Received:
January 5,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 Published by Elsevier Inc.
