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Gynaecological Skin, Soft-Tissue Infections Should Be Tested for Methicillin-Resistant Staphylococcus aureus: Presented at ACOG By Bruce Sylvester CHICAGO -- May 8, 2009 -- Cultures should be taken from all patients presenting with a gynaecological skin and soft-tissue infection and then evaluated for community-acquired methicillin-resistant Staphylococcus aureus (MRSA), researchers stated here on May 4 at the 57th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists (ACOG). "We found significant underculturing and therefore undertreatment of patients in our community setting who present with Bartholin's or labial abscesses," said Barbara Chen, MD, Methodist Dallas Medical Center, Dallas, Texas. "The MRSA problem is growing, and, in this study, we draw attention to a neglected area of diagnosis and treatment," she added. The researchers conducted a retrospective chart review, including demographics, medical history, culture results, and antimicrobial therapy, to identify Bartholin's and labial abscesses in the urban community around the Methodist Dallas Medical Center from January 1, 2002, through December 31, 2007. A total of 320 cases -- 297 women with Bartholin's or labial abscesses, 20 of whom had recurrences -- were studied (116 Bartholin's and 204 labial abscesses). Half of the 45% of cases from which cultures were not obtained had comorbid conditions, including diabetes, illicit drug use, and immunodeficiency. Of the 137 cultured abscesses, 31% (6 Bartholin's, 36 labial) proved positive for community-acquired MRSA, which was the most common isolate found in labial abscesses (27%). Of the MRSA cases, 36% necessitated inpatient intravenous antimicrobial therapy. All abscesses with MRSA drained spontaneously or by incision. The most common outpatient therapy was the antibiotic trimethoprim-sulfamethoxazole (100% susceptibility). "This study is the first to report community-acquired MRSA in Bartholin's abscesses in the urban, community setting," the researchers noted. To determine whether community-acquired MRSA is a growing problem in gynaecological skin and soft-tissue infections, the researchers recommend that culture specimens be obtained from all abscesses. [Presentation title: Community-Acquired MRSA in Skin and Soft-Tissue Gynecological Infections. Abstract 29] E-mail this page to a friend or colleague! To print, use this version