Methicillin-resistant Staphylococcus aureus in acute otitis externa

Objective: Otologic methicillin-resistant Staphylococcus aureus (MRSA) infection has historically been rare, but given the rise in community-acquired MRSA carriage and infection at other body sites, prevalence rates may be changing. The goal of this study was to determine the prevalence of MRSA in r...

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Autores principales:	Maria J. Duarte, Elliott D. Kozin, Paulo J.M. Bispo, Andreas H. Mitchell, Michael S. Gilmore, Aaron K. Remenschneider
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2018
Materias:	Otorhinolaryngology RF1-547 Surgery RD1-811
Acceso en línea:	https://doaj.org/article/31d6b6258edb439da080829e0b6c02b2
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spelling	oai:doaj.org-article:31d6b6258edb439da080829e0b6c02b22021-12-02T12:04:51ZMethicillin-resistant Staphylococcus aureus in acute otitis externa2095-881110.1016/j.wjorl.2017.09.003https://doaj.org/article/31d6b6258edb439da080829e0b6c02b22018-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095881117300434https://doaj.org/toc/2095-8811Objective: Otologic methicillin-resistant Staphylococcus aureus (MRSA) infection has historically been rare, but given the rise in community-acquired MRSA carriage and infection at other body sites, prevalence rates may be changing. The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa (AOE). Study design: Retrospective review of an institutional microbiologic database. Methods: A retrospective analysis was performed on serial culture isolates taken from the ear at a quaternary care hospital from January 2014 to April 2016. The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration (MIC) testing. Medical records were reviewed to document patient characteristics, chronicity of infection, symptomatology, and previous treatments. Results: Over the study period, 173 patients were diagnosed with AOE and underwent otologic cultures of the ear. Fifty-three (30.6%) of cultures grew S. aureus (SA). Of SA infections, 15 (28.3%) were identified as MRSA. MRSA patients were typically older than patients with methicillin-sensitive SA (MSSA) (mean age 46.7 ± 17.9 vs 29 ± 19.4, P = 0.003) and had more medical comorbidities (4 vs 1.7, P = 0.001). Compared to patients with MSSA, patients with MRSA were significantly more likely to have had prior ototopical antibiotic exposure (37% vs 73%, P = 0.019). Conclusion: Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature. Clinicians should consider ear cultures to identify MRSA AOE. Level of Evidence: IV. Keywords: Acute otitis externa, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, MRSAMaria J. DuarteElliott D. KozinPaulo J.M. BispoAndreas H. MitchellMichael S. GilmoreAaron K. RemenschneiderKeAi Communications Co., Ltd.articleOtorhinolaryngologyRF1-547SurgeryRD1-811ENWorld Journal of Otorhinolaryngology-Head and Neck Surgery, Vol 4, Iss 4, Pp 246-252 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Otorhinolaryngology RF1-547 Surgery RD1-811
spellingShingle	Otorhinolaryngology RF1-547 Surgery RD1-811 Maria J. Duarte Elliott D. Kozin Paulo J.M. Bispo Andreas H. Mitchell Michael S. Gilmore Aaron K. Remenschneider Methicillin-resistant Staphylococcus aureus in acute otitis externa
description	Objective: Otologic methicillin-resistant Staphylococcus aureus (MRSA) infection has historically been rare, but given the rise in community-acquired MRSA carriage and infection at other body sites, prevalence rates may be changing. The goal of this study was to determine the prevalence of MRSA in recent otologic cultures from patients with acute otitis externa (AOE). Study design: Retrospective review of an institutional microbiologic database. Methods: A retrospective analysis was performed on serial culture isolates taken from the ear at a quaternary care hospital from January 2014 to April 2016. The causative pathogen and antibiotic sensitivity was determined by culture isolation and end point mean inhibitory concentration (MIC) testing. Medical records were reviewed to document patient characteristics, chronicity of infection, symptomatology, and previous treatments. Results: Over the study period, 173 patients were diagnosed with AOE and underwent otologic cultures of the ear. Fifty-three (30.6%) of cultures grew S. aureus (SA). Of SA infections, 15 (28.3%) were identified as MRSA. MRSA patients were typically older than patients with methicillin-sensitive SA (MSSA) (mean age 46.7 ± 17.9 vs 29 ± 19.4, P = 0.003) and had more medical comorbidities (4 vs 1.7, P = 0.001). Compared to patients with MSSA, patients with MRSA were significantly more likely to have had prior ototopical antibiotic exposure (37% vs 73%, P = 0.019). Conclusion: Contemporary ear culture isolates at quaternary care center show higher rates of MRSA compared to historical reports in the literature. Clinicians should consider ear cultures to identify MRSA AOE. Level of Evidence: IV. Keywords: Acute otitis externa, Staphylococcus aureus, Methicillin-resistant Staphylococcus aureus, MRSA
format	article
author	Maria J. Duarte Elliott D. Kozin Paulo J.M. Bispo Andreas H. Mitchell Michael S. Gilmore Aaron K. Remenschneider
author_facet	Maria J. Duarte Elliott D. Kozin Paulo J.M. Bispo Andreas H. Mitchell Michael S. Gilmore Aaron K. Remenschneider
author_sort	Maria J. Duarte
title	Methicillin-resistant Staphylococcus aureus in acute otitis externa
title_short	Methicillin-resistant Staphylococcus aureus in acute otitis externa
title_full	Methicillin-resistant Staphylococcus aureus in acute otitis externa
title_fullStr	Methicillin-resistant Staphylococcus aureus in acute otitis externa
title_full_unstemmed	Methicillin-resistant Staphylococcus aureus in acute otitis externa
title_sort	methicillin-resistant staphylococcus aureus in acute otitis externa
publisher	KeAi Communications Co., Ltd.
publishDate	2018
url	https://doaj.org/article/31d6b6258edb439da080829e0b6c02b2
work_keys_str_mv	AT mariajduarte methicillinresistantstaphylococcusaureusinacuteotitisexterna AT elliottdkozin methicillinresistantstaphylococcusaureusinacuteotitisexterna AT paulojmbispo methicillinresistantstaphylococcusaureusinacuteotitisexterna AT andreashmitchell methicillinresistantstaphylococcusaureusinacuteotitisexterna AT michaelsgilmore methicillinresistantstaphylococcusaureusinacuteotitisexterna AT aaronkremenschneider methicillinresistantstaphylococcusaureusinacuteotitisexterna
_version_	1718394681833816064

Methicillin-resistant Staphylococcus aureus in acute otitis externa

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