کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3248974 1589156 2012 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Clinical and Epidemiologic Characteristics as Predictors of Treatment Failures in Uncomplicated Skin Abscesses Within Seven Days After Incision and Drainage
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
پیش نمایش صفحه اول مقاله
Clinical and Epidemiologic Characteristics as Predictors of Treatment Failures in Uncomplicated Skin Abscesses Within Seven Days After Incision and Drainage
چکیده انگلیسی

BackgroundCommunity-acquired methicillin-resistant Staphylococcus aureus (MRSA) is now the leading cause of superficial abscesses seen in the Emergency Department.Study ObjectivesOur primary aim was to determine if an association exists between three predictor variables (abscess size, cellulitis size, and MRSA culture) and treatment failure within 7 days after incision and drainage in adults. Our secondary aim was to determine if an association exists between two clinical features (abscess size and size of surrounding cellulitis) and eventual MRSA diagnosis by culture.MethodsLogistic regression models were used to examine clinical variables as predictors of treatment failure within 7 days after incision and drainage and MRSA by wound culture.ResultsOf 212 study participants, 190 patients were analyzed and 22 were lost to follow-up. Patients who grew MRSA, compared to those who did not, were more likely to fail treatment (31% to 10%, respectively; 95% confidence interval [CI] 8–31%). The failure rates for abscesses ≥ 5 cm and < 5 cm were 26% and 22%, respectively (95% CI −11–26%). The failure rates for cellulitis ≥ 5 cm and < 5 cm were 27% and 16%, respectively (95% CI −2–22%). Larger abscesses were no more likely to grow MRSA than smaller abscesses (55% vs. 53%, respectively; 95% CI −22–23%). The patients with larger-diameter cellulitis demonstrated a slightly higher rate of MRSA-positive culture results compared to patients with smaller-diameter cellulitis (61% vs. 46%, respectively; 95% CI −0.3–30%), but the difference was not statistically significant.ConclusionCellulitis and abscess size do not predict treatment failures within 7 days, nor do they predict which patients will have MRSA. MRSA-positive patients are more likely to fail treatment within 7 days of incision and drainage.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Emergency Medicine - Volume 43, Issue 4, October 2012, Pages 605–611
نویسندگان
, , , , , ,