Skip Navigation Archive: U.S. Department of Health and Human Services U.S. Department of Health and Human Services
Archive: Agency for Healthcare Research Quality www.ahrq.gov
AHRQ Home—Live Site | Archive Home | Site Map
Archival print banner

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to www.ahrq.gov for current information.

Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms

Tables 1-7

Table 1. Summary of interventions by office

Office

Intervention

The Country Doctor, Bloomfield
Dr. Brodale

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds)

Manchester Family Medicine Associates, Guttenberg
Dr. Hoffman

CDC Algorithm for MRSA Treatment (will put on EMRelectronic medical record)
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)
Office policy for patients with skin infections

Genesis Medical Center, Blue Grass
Dr. Bunting

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

Genesis Medical Center, Davenport
Dr. Andresen

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

Medical Associates, Le Mars
Dr. Doorenbos

CDC Algorithm for MRSA Treatment
Office policy for patients with skin infections (extant)
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

Regional Family Health, Manchester
Dr. Boom

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

University of Iowa Hospitals and Clinics CMS Lone Tree Clinic, (Moved to Riverside on March 15, 2010)
Dr. Bedell

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

University of Iowa Hospitals and Clinics CMS Sigourney Clinic
Dr. Saxena

CDC Algorithm for MRSA Treatment
Office skin infection management protocol
Education forms (MRSA Fact Sheet, & Caring for Wounds)
Office skin infection management protocol

University of Iowa Hospitals and Clinics Family Medicine Clinic, Iowa City
Dr. Wilbur

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

Urbandale Family Physicians, Urbandale
Dr. Shirk

CDC Algorithm for MRSA Treatment
Education forms (MRSA Fact Sheet, Caring for Wounds, Wound Packing Instructions)

Return to Contents

Table 2. Skin infection forms received by study site

IRENE Office (Office No.)

City

City Population

No. of Skin and Soft Tissue Forms Returned

The Country Doctor (6)

Bloomfield

2,601

21
Family Medicine Associates (3)

Guttenberg

1,987

30

Genesis Family Medicine (1)

Davenport

98,359

31

Genesis Family Medicine (2)

Blue Grass

1,169

30
Manchester Family Medical Associates (4)

Manchester

5,257

30

Medical Associates (5)

Le Mars

9,237

30

University of Iowa Hospitals and Clinics CMS Riverside Clinic (7)

Riverside

928

30

University of Iowa Hospitals and Clinics CMS Sigourney Clinic (8)

Sigourney

2,209

33

University of Iowa Hospitals and Clinics Family Medicine Clinic (9)

Iowa City

62,220

30

Urbandale Family Physicians (10)

Urbandale

29,072

30

Return to Contents

Table 3. Demographic characteristics by clinic site

Clinic No. Useable Skin
and Soft Tissue
Infection Forms		 Male
n (%)		 Uninsured
n (%)		 Mean Age
(Years)		 Rural County
n (%)

1

25

7 (28)

1 (4)

40

0

2

26

12 (46)

0

40

0

3

26

14 (54)

1 (4)

53

25 (96)

4

26

4 (15)

1 (4)

44

1 (4)

5

29

22 (76)

6 (21)

39

0

6

21

12 (57)

3 (16)

30

20 (95)

7

25

16 (64)

3 (12)

46

9 (36)

8

26

17 (68)

0

35

25 (100)

9

30

11 (37)

1 (3)

38

0

10

30

17 (57)

2 (7)

43

0

Total

263

132 (50%)

18 (7)

41

80 (30)

Return to Contents

Table 4. Demographic summary of retrospective study subjects

Demographics (N = 263)

N (%)

Age (years)
   > 20
   20-39
   40-64
   ≥ 65

60 (23)
66 (25)
88 (34)
48 (18)

Male

132 (50)

Caucasian

191 (96)

Hispanic

10 (5)

Insurance coverage
   Private
   Medicaid
   Medicare
   Uninsured

152 (59)
44 (17)
44 (17)
18 (7)

Lives in rural county

80 (30)

Return to Contents

Table 5. Skin infection type, incision and drainage done, culture sent, initial antibiotic prescribed, and MRSA in wound for retrospective subjects

Clinic

No. Useable Skin
and Soft Tissue
Infection Forms n (%)

Abscess
Only
n (%)

Cellulitis
Only
n (%)

Both Abscess & Cellulitis
n (%)

Incision and Drainage Done
n (%)

Culture Sent
n (%)

Initial antibiotic prescribed
n (%)

MRSA positive
(n)

1

25

22 (88)

0

3 (12)

25 (100)

5 (20%)

16 (64)

2

2

26

13 (50)

13 (50)

0

10 (39)

0

25 (96)

0

3

26

4 (15)

16 (62)

6 (23)

6 (23)

10 (39)

26 (100)

1

4

26

2 (8)

20 (77)

4 (15)

3 (12)

4 (15)

26 (100)

0

5

29

12 (41)

12 (41)

5 (18)

10 (35)

19 (66)

28 (97)

19

6

21

7 (33)

10 (48)

4 (19)

7 (33)

13 (62)

21 (100)

5

7

25

5 (20)

20 (80)

0

3 (12)

3 (12)

23 (92)

0

8

25

2 (8)

19 (76)

4 (16)

3 (12)

16 (64)

24 (96)

8

9

30

12 (40)

17 (57)

1 (3)

6 (20)

11 (37)

30 (100)

6

10

30

15 (50)

14 (47)

1 (3)

13 (43)

11 (37)

29 (97)

4

Total

263

94 (36)

141 (54)

28 (11)

86 (32)

92 (35)

248 (94)

      45

Return to Contents

Table 6. Treatment according to infection type, retrospective data

 

Abscess Only
n = 93
n (%)

Cellulitis Only
n = 143
n (%)

Both Abscess and Cellulitis
n = 27
n (%)

P-value

Incision and drainage

68 (73)

Not applicable

15 (56)

0.082

Wound packed

22 (24)

Not applicable

8 (30)

0.126

Cultured

40 (43)

34 (24)

18 (67)

<0.001

MRSA identified

25 (27)

9 (6)

11 (41)

<0.001

Any antibiotic prescribed at the initial visit

81 (87)

138 (97)

27 (100)

0.006

Number of antibiotics used until infection healed
   0
   1
   2
   3
   4
   5

 
11 (12)
60 (65)
16 (17)
5 (5)
1 (1)
0

 
4 (3)
103 (72)
25 (18)
7 (5)
2 (1)
2 (1)

0
13 (48)
9 (33)
4 (15)
0
1(4)

0.015

Total number of antibiotics prescribed:
    > 2
    ≤ 2

6 (7)
8 (93)

11 (8)
132 (92)

5 (19)
22 (81)

0.125

First or second antibiotic prescribed at initial visit covered MRSA

35 (43)

24 (17)

11 (41)

<0.001

MRSA coverage at any time

44 (54)

35 (25)

12 (44)

<0.001

Mean time (days) to resolution

10.5 (6.1)

12.3 (8.1)

14.0 (8.6)

0.059

Return to Contents

Table 7. Abscess treatment by incision and drainage done versus not, retrospective data

 

Abscess Only
Incised and Drained
N = 68
N (%)

Abscess Only
Not Incised and Drained
N = 25
N (%)

P-value

Wound packed

22 (100)

Not applicable

 

Cultured

31 (46)

9 (36)

0.408

MRSA identified (of those cultured)

16 (24)

9 (36)

0.032

Any antibiotic prescribed at the initial visit

56 (82)

25 (100)

0.024

Number antibiotics used
   0
   1
   2
   3
   4

11 (16)
41 (60)
13 (19)
2 (3)
1 (2)

0
19 (76)
3 (12)
3 (12)
0

0.077

Total number of antibiotics prescribed:
> 2
≤ 2

3 (4)
65 (96)

3 (12)
22 (88)

0.187

First or second antibiotic prescribed at initial visit covered MRSA

26 (46)

9 (36)

0.381

MRSA coverage at any time

32 (56)

12 (48)

0.496

Mean time to resolution (days)

9.6 (5.3)

12.8 (7.5)

0.059

Return to Contents
Proceed to Next Section

Page last reviewed October 2014
Page originally created September 2012
Internet Citation: Tables 1-7. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. https://archive.ahrq.gov/research/findings/final-reports/mrsa/iowa_mrsatabs1-7.html

The information on this page is archived and provided for reference purposes only.

 
AHRQ Advancing Excellence in Health Care