Community-Acquired Skin Infections in the Age of Methicillin-Resistant Organisms
Tables 8-11
Table 8. Time to resolution of infection (days), univariate analyses retrospective information
N =263
|
N |
Time to Resolution |
ANOVA |
|
|---|---|---|---|
| Gender | |||
|
Female |
131 |
10.8 ± 6.3 | |
|
Male |
132 |
12.9 ± 8.6 |
0.028 |
|
|
|||
|
Age group (years) |
|||
|
< 20 |
60 |
10.8 ± 4.5 | |
|
20 to < 40 |
66 |
11.4 ± 6.2 | |
|
40 to < 65 |
88 |
12.6 ± 10.1 | |
|
65 to 96 |
48 |
12.4 ± 7.1 |
0.467 |
|
|
|||
|
Age group (years) |
|||
|
< 40 |
126 |
11.2 ± 5.5 | |
|
40 and older |
136 |
12.6 ± 9.1 |
0.129 |
|
|
|||
|
Total number of antibiotics used over course of infection |
|||
|
0 |
15 |
8.3 ± 5.9 | |
|
1 |
176 |
9.6 ± 3.7 | |
|
2 |
50 |
16.0 ± 10.3 | |
|
3 |
16 |
21.1 ± 10.0 | |
|
4 |
3 |
22.7 ± 12.6 | |
|
5 |
3 |
30.7 ± 14.6 |
< 0.001 |
|
|
|||
|
Total number of antibiotics used |
|||
|
< 2 |
241 |
10.9 ± 6.4 | |
|
> 2 |
22 |
22.6 ± 10.9 |
< 0.001 |
|
|
|||
|
Classification of infection |
|||
|
Abscess only |
94 |
10.6 ± 6.1 |
|
|
Cellulitis only |
141 |
12.3 ± 8.2 | |
|
Abscess & cellulitis |
28 |
13.7 ± 8.6 |
.088 |
|
|
|||
|
Rurality of subject |
|||
|
Non-rural |
183 |
10.7 ± 6.3 | |
|
Rural |
80 |
14.6 ± 9.0 |
< 0.001 |
|
|
|||
|
Face/neck |
34 |
13.5 ± 10.7 | |
|
Groin/pubic/lower extremities |
122 |
13.4 ± 8.5 | |
|
Thorax/upper extremities |
104 |
9.6 ± 4.1 |
< 0.001 |
|
|
|
|
|
|
Subject hospitalized |
|||
|
Yes |
11 |
21.6 ± 14.9 | |
|
No |
252 |
11.4 ± 6.8 |
< 0.001 |
|
|
|||
|
Initial temperature (°F) (not everyone had a temperature recorded) |
|||
|
< 99 |
206 |
11.5 ± 7.3 | |
|
99 and above |
24 |
15.1 ± 10.0 |
0.031 |
|
|
|||
|
Initial antibiotics given covered MRSA during infection (not everyone received an antibiotic) |
|||
|
Yes |
70 |
11.4 ± 6.6 | |
|
No |
176 |
12.3 ± 8.0 |
0.421 |
|
|
|
||
|
Antibiotics given covered MRSA at some point during infection (not everyone received an antibiotic) |
|||
|
Yes |
91 |
13.3 ± 8.3 | |
|
No |
157 |
11.4 ± 7.1 |
0.064 |
|
|
|||
|
Incision and drainage done |
|||
|
Yes |
85 |
10.2 ± 5.6 | |
|
No |
178 |
12.7 ± 8.3 |
0.014 |
|
|
|||
|
Wound packed |
|||
|
Packed |
30 |
9.8 ± 6.9 | |
|
Not packed |
55 |
10.5 ± 4.8 | |
|
Incision and drainage not done |
178 |
12.7 ± 8.3 |
0.046 |
|
|
|||
|
Only for those (n = 85) who had incision and drainage |
|||
|
Wound packed |
30 |
9.6 ± 6.9 | |
|
Wound not packed |
55 |
10.5 ± 4.8 |
0.592 |
|
|
|||
|
MRSA identified vs. others |
|
|
|
|
MRSA identified |
45 |
13.3 ± 6.2 | |
|
All others |
218 |
11.6 ± 7.8 |
0.160 |
|
|
|||
|
Patient risk factors (at least one of 13 risk factors) |
|
||
|
At least one of risk factors |
69 |
13.8 ± 8.9 | |
|
No risk factors |
194 |
11.2± 6.9 |
0.016 |
Table 9. Time to resolution using cox proportional hazards regression for retrospective data
N=260 cases, controlling for clinic-level clustering
Patient Characteristics
| Variable | Hazard Ratio* | P-Value |
|---|---|---|
|
Male (vs. female) |
0.831 | <.0001 |
|
Rural (vs. urban) |
0.657 | .0009 |
|
At least one MRSA risk factor (vs. none) |
0.782 | .0470 |
|
Infection Site (vs. thorax/upper extremity) |
||
|
Face/neck |
0.549 | .0054 |
|
Groin/pubic area/lower extremity |
0.574 | <.0001 |
Patient and Clinical Characteristics†
| Variable | Hazard Ratio* | P-Value |
|---|---|---|
|
Age <40 yrs. (vs. ≥ 40 yrs.) |
1.088 | N.S. |
|
Male (vs. female) |
0.838 | .0003 |
|
Rural (vs. urban) |
0.718 | .0194 |
|
At least one MRSA risk factor (vs. none) |
0.844 | .1427 |
|
Infection Site (vs. thorax/upper extremity) |
||
|
Face/neck |
0.548 | .0014 |
|
Groin/pubic area/lower extremity) |
0.564 | <.0001 |
|
Total number of antibiotics prescribed over course of infection ≤2 (vs. >2) |
2.797 | <.0001 |
|
Patient hospitalized (vs. not) |
0.567 | .0135 |
|
MRSA identified (vs. not) |
0.862 | .0633 |
†Controlled for age category
*Hazard ratio: a value less than 1 means the infection is less likely to resolve at any given time point with the factor present; a value greater than 1 means the infection is more likely to resolve with the factor present.
Table 10. Prospective skin forms returned by clinic
| IRENE Office (Office No.) |
City |
No. Prospective Skin |
No. Prospective Skin |
|---|---|---|---|
|
Family Medicine Associates (3) |
Guttenberg |
24 |
23 |
|
Genesis Family Medicine (1) |
Davenport |
10 |
8 |
|
Genesis Family Medicine (2) |
Blue Grass |
1 |
0 |
|
Manchester Family Medical Associates (4) |
Manchester |
9 |
9 |
|
Medical Associates (5) |
Le Mars |
11 |
11 |
|
The Country Doctor (6) |
Bloomfield |
0 |
0 |
|
University of Iowa Hospitals and Clinics CMS Riverside Clinic (7) |
Riverside |
7 |
5 |
|
University of Iowa Hospitals and Clinics CMS Sigourney Clinic (8) |
Sigourney |
12 |
10 |
|
University of Iowa Hospitals and Clinics Family Medicine Clinic (9) |
Iowa City |
30 |
30 |
|
Urbandale Family Physicians (10) |
Urbandale |
18 |
18 |
|
Total |
|
122 |
114 |
Table 11. Demographic information from prospective skin and soft tissue infection forms
| Clinic |
No. Useable Skin |
Male |
Uninsured |
Mean Age |
Rural County |
|---|---|---|---|---|---|
|
1 |
8 |
0 |
1 (4) |
41 |
0 |
|
2 |
0 |
0 |
0 |
0 |
0 |
|
3 |
23 |
11 (48) |
0 |
42 |
20 (91) |
|
4 |
9 |
4 (44) |
0 |
36 |
1 (11) |
|
5 |
11 |
6 (55) |
0 |
30 |
0 |
|
6 |
0 |
0 |
0 |
0 |
0 |
|
7 |
5 |
5 (100) |
0 |
24 |
0 |
|
8 |
10 |
5 (50) |
1 (9) |
32 |
10 (100) |
|
9 |
30 |
10 (33) |
0 |
43 |
0 |
|
10 |
18 |
7 (39) |
0 |
44 |
0 |
|
Total |
114 |
48 (42) |
2 (2) |
39 |
31 (27) |
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