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Methicillin-resistant Staphylococcus aureus in skin and soft tissue infections and minocyclin treatment experience in the dermatological setting of eastern Taiwan
Tzu-Chun Lin , Cheng-Huang Chang , Song-Jen Hong , Yeong-Chuan Tsai , Chung-Hsing Chang
DERMATOLOGICA SINICA 29 (2011) 86-90

Background
Staphylococcus aureus (S aureus) is the major cause of skin and soft tissue infections (SSTIs). Increased methicillin-resistant strains have attracted a global concern. The aim of this study is to evaluate the prevalence of methicillin-resistant S aureus (MRSA) SSTIs in dermatologic settings and evaluate their susceptibility results.

Methods
A retrospective chart analysis of patients diagnosed with SSTIs in the Department of Dermatology, Buddhist Tzu Chi General Hospital in Hualien, Taiwan from November 2003 to July 2007 was conducted. Wound or pus bacterial culture results from a wound site were collected. The epidemiology, microbiology, and antibiotic susceptibility were assessed. Minocycline treatment experience in 15 MRSA SSTIs inpatients was presented.

Results
Of the 443 SSTI episodes included, 59.6% were males and 40.4% were females. S aureus was the leading cause (53.3%), and among them 53.0% were MRSA. Minocycline (94.4%), trimethoprim/sulfamethoxazole (95.2%), levofloxacin (95.7%), and fusidic acid (98.9%) were the major susceptible antimicrobial agents to MRSA. Only 14.4% was susceptible to clindamycin. In the MRSA infected inpatients, 75.6% were community-associated. In our clinical experience, 15 inpatients with poor clinical response to beta-lactam empirical antimicrobial therapy received minocycline as combination therapy based on the susceptibility results, all of which obtained satisfied clinical remission.

Conclusions
S aureus is still the leading causative bacterial organism for SSTIs in the dermatologic settings in eastern Taiwan. Methicillin-resistant strains are increasing and among which most are community-associated in eastern Taiwan. MRSA strains are still susceptible to other non-beta lactam antibiotics, such as minocycline, trimethoprim/sulfamethoxazole, levofloxacin, and fusidic acid in dermatological settings, of which minocycline is an alternative choice in our clinical experience.

   
   
 
 
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