Community-acquired methicillin-resistant Staphylococcus aureus: an emerging pathogen in orthopaedics

J Am Acad Orthop Surg. 2008 Feb;16(2):98-106. doi: 10.5435/00124635-200802000-00007.

Abstract

Staphylococcus aureus (S aureus) remains one of the most common pathogens for skin and soft-tissue infections encountered by the orthopaedic surgeon. Community-acquired methicillin-resistant S aureus (CA-MRSA) has become increasingly prevalent, particularly among athletes, children in day care, homeless persons, intravenous drug users, men who have sex with men, military recruits, certain minorities (ie, Alaskan Natives, Native Americans, Pacific Islanders), and prison inmates. Risk factors include antibiotic use within the preceding year, crowded living conditions, compromised skin integrity, contaminated surfaces, frequent skin-to-skin contact, shared items, and suboptimal cleanliness. When a patient presents with a skin or soft-tissue infection, the clinician should determine whether an abscess or other infection needs to be surgically incised and drained. Cultures should be performed. When the patient is a member of an at-risk group or has any of the risk factors for CA-MRSA, beta-lactam antibiotics (eg, methicillin) are no longer a reasonable choice for treatment. Empiric treatment should consist of non-beta-lactam antibiotics active against CA-MRSA.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy*
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / surgery
  • Diagnosis, Differential
  • Disease Progression
  • Humans
  • Methicillin Resistance*
  • Orthopedics*
  • Prevalence
  • Risk Factors
  • Soft Tissue Infections / diagnosis
  • Soft Tissue Infections / drug therapy*
  • Soft Tissue Infections / epidemiology
  • Soft Tissue Infections / surgery
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / surgery
  • Staphylococcal Skin Infections / diagnosis
  • Staphylococcal Skin Infections / drug therapy*
  • Staphylococcal Skin Infections / epidemiology
  • Staphylococcal Skin Infections / surgery
  • Staphylococcus aureus / pathogenicity

Substances

  • Anti-Bacterial Agents