Genitourinary Skin And Soft Tissue Infections: A Prospective Contemporary Evaluation Of Causative Pathogens
Abstract
Purpose
Prior literature identified anaerobes as the predominant causative organisms in genitourinary skin and soft tissue infections (SSTIs). The rising prevalence of community-acquired methicillin-resistantStaphylococcus aureus (CA-MRSA) infections, however, has brought about growing need to reevaluate these infections and their causative organisms. This study examines the causative organisms and risk factors in suppurative superficial genitourinary infections, and evaluates the growing role of CA-MRSA.
Materials and Methods
We performed a single-institution prospective assessment of 60 adults presenting, between August 2008 and July 2010, with genitourinary SSTIs requiring incision and drainage. Patients completed a standardized, non-validated questionnaire prior to undergoing debridement of the site.
Results
Sixty patient specimens were obtained and ninety-two bacterial pathogens were isolated. Of these pathogens, 55% were aerobes.Staphylococcus aureus was the most predominant cultured organism, representing 25% of all cultured organisms, and 65% of these isolates were CA-MRSA. The most commonly associated comorbidities included diabetes mellitus, tobacco smoking, and heavy alcohol use. HIV/AIDS demonstrated a statistically significant association with CA-MRSA infection (odds ratio [OR], 11.00; 95% confidence interval [CI], 1.05-115.51; P-value 0.0456), as did the cumulative number of CA-MRSA risk factors (OR, 2.64; CI, 1.31-5.33; P = 0.007).
Conclusions
Aerobic organisms now account for majority of these infections and CA-MRSA has emerged as a significant causative organism. Populations that may be at increased risk for these infections include patients with diabetes mellitus, heavy alcohol users, and tobacco smokers. Patients with HIV/AIDS or multiple CA-MRSA risk factors are more likely to have CA-MRSA as the causative organism.
http://www.jurology.com/article/S0022-5347(13)00369-8/abstract
