Case series of Community Acquired Methicillin Resistant Staphylococcus Aureus

Abstract

Background: Community acquired methicillin resistant Staphylococcus Aureus (CA-MRSA) is one of the most recognized emerging pathogen of the last decade. It is mostly associated with skin and soft tissues infections causing severe complications. In our country the prevalence of infections caused by this agent remains unknown Methods & Materials: Retrospective, descriptive, transversal study. The information was obtained from medical records revision. It was analyzed microbiologic diagnostic of CA-MRSA in hospitalized patients over 18 years old, from the months of January 2011 to June 2017. Results: There were included 62 patients. The median age was 41.6 years, 79% were men. Diabetes (29%) and cancer (12%) were the most common comorbidity founded. 58% of the included population was smoker. 43% of the patients had received antibiotics before and only 7% had had a previous history of CA-MRSA infection. Regarded with the yearly. The 66% of the cases ocurred during the last thirty months. Skin and soft tissues infection was the most frequent disease(38.7%) and a third of the patients that had this type of infection presented bacteremia as complication. Others infections caused by CA-MRSA were: bacteremia only (29%), abscess (12,8%), acute osteomyelitis (8,1%) and pneumonia(9.7%). Regarding to the antibiotic sensitivity pattern, during the analysis of the first four years, resistance to Vancomycin was not present. There was also no resistance to Clindamycin until 2014. Related to Trimetropin/Cotrimoxazol sensitivity, there was no resistance during the first 3 years. Resistance to Rifampicin was not detected in the first 4 years. Ciprofloxacin had 0% resistance in the first 4 years. Ciprofloxacin associated with Clindamycin was the empiric antibiotic therapy most commonly used (50-60%) in the first years, whereas in the last 30 months TMS plus Ampicilin/Sulbactam was the combination preferred. Conclusion: CA – MRSA infection was more frequent in man of middle age, observing an increasing amount of cases in the last two years.The risk factors and comorbidity presented in the population studied were HTA, DBT, smoking and previous antibiotic treatment. Skin and soft tissue infection was the most common disease. An increase of antibiotic resistance to Clindamycin and Ciprofloxacin was notorious.