The epidemiology of hand infections and incidence of community acquired methicillin resistant staphylococcus aureus at Chris Hani Baragwanath academic hospitalri

Abstract

Hand Infections lead to tissue destruction, disability and financial burden. Most treatment protocols underpin Methicillin based antibiotics despite rising incidence of CA-MRSA, this study aims to assess said incidence in our community and its impact on treatment. This was a prospective cross sectional analytical study performed at Chris Hani Baragwanath Academic Hospital over a 6 month period ending 31 March 2017 of all non-surgical site hand infections. Data was collected via patient questionnaire, theatre note review and microbiology results. Our results demonstrated a predominance of Methicillin Sensitive Staphylococcus Aureus (n = 121) and an incidence of CA-MRSA of 2.5%. Our results show a statistically significant rate of repeat procedures and amputations in the CA-MRSA group especially if HIV positive (p = 0.0125). Based on the above findings we cannot recommend routine empiric Oxazolidinone therapy to cover CA-MRSA. We however wish to highlight CA-MRSA as an emerging pathogen especially in the HIV positive subgroup.