Methicillin-resistant Staphylococcus aureus in communityacquiredpyoderma
2004
Background
Methicillin-resistant
Staphylococcus aureus
(MRSA) is an important nosocomial
pathogen. It can also cause community-acquired infections. Indian reports about MRSA in
community-acquired infections are rare.
Aim
To evaluate the rate of MRSA in community-acquired pyoderma and the nasal colonisation
with
S. aureus
in such patients.
Methods
Two hundred and fifty patients with community-acquired pyoderma, who attended
outreach camps around Mangalore, south India between January 2000 and July 2001, were
studied. Swabs collected from the skin lesions and anterior nares were inoculated onto blood
agar and MacConkey’s agar. Antimicrobial sensitivity testing was performed using Kirby–Bauer
disk diffusion, agar dilution, and agar screen.
Results
Of 250 pyoderma cases,
S. aureus
was isolated from 202 (80.8%) patients. Twentytwo
(10.9%)
S. aureus
isolates were methicillin resistant, 179 (88.6%) were resistant to
penicillin, and 114 (56.4%) were resistant to erythromycin.
S. aureus
colonization in the anterior
nares was observed in 136 (54.4%) cases, 11.8% of which were MRSA. Antibiograms of clinical
isolates of
S. aureus
matched with nasal isolates in 99 (49%) cases.
Conclusion
The emergence of MRSA in the community is a warning. A high nasal carriage
rate may contribute to recurrent pyoderma. A correct antimicrobial policy and the avoidance of
inappropriate antimicrobial usage are mandatory to reduce the spread of MRSA in the
community.
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