The Retrospective Prevalence of Community-Acquired Methicillin-ResistantStaphylococcus aureusin Soft Tissue Abscesses at Two Military Level I Trauma Centers
Many studies have shown that community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) is a very prevalent organism. However, no data have been published to date with regard to CAMRSA prevalence in patients presenting to the emergency department (ED) of a military medical facility. Our objective is to estimate the period prevalence of CAMRSA in cases of soft tissue abscesses seen in the emergency departments of two major military hospitals. A retrospective review of electronic records was performed from January 1, 2004 to August 10, 2005. This database was used to identify patients with the diagnosis of abscess, the procedure code for incision and drainage, and culture of wound. After data were accumulated, standard prevalence calculations were applied to determine prevalence of CAMRSA in abscesses at our emergency departments. Antibiotic susceptibilities were then evaluated with regard to the CAMRSA bacteria. The prevalence at our two emergency departments was 68% (751 abscesses, 220 cultured, 155 methicillin-resistant S. aureus (MRSA)-positive cultures). The prevalence at Brooke Army Medical Center and Wilford Hall Medical Center emergency departments was 70% (520 abscesses, 145 cultured, and 101 MRSA positive) and 65% (231 abscesses, 75 cultured, and 49 MRSA positive), respectively. The occurrence of CAMRSA is not isolated to the civilian population. The prevalence of CAMRSA in this population is significant, and may pose serious operational and deployment-related ramifications requiring the attention of military medical planners as well as forward medical care providers. The probability of CAMRSA infection should be considered when treating soft tissue abscesses in the military emergency department.