ABSTRACT
The number of complicated skin and soft tissue infections (cSSTIs) in the Arabian Gulf region has risen in recent years, particularly those caused by multi-drug resistant (MDR) pathogens. The high prevalence of diabetes, obesity, and associated cardio-metabolic comorbidities in the region renders medical and surgical management of cSSTI patients with MDR infections challenging. An experienced panel of international and regional cSSTI experts (consensus group on cSSTIs) was convened to discuss clinical considerations for MDR infections from societal, antimicrobial stewardship, and cost perspectives, to develop best practice recommendations. This article discusses antibiotic therapies suitable for treating MDR cSSTIs in patients from the Gulf region and recommends that these should be tailored according to the local bacterial ecology by country and region. The article highlights the need for a comprehensive patient treatment pathway and defined roles of each of the multidisciplinary teams involved with managing patients with MDR cSSTIs. Aligned and inclusive definitions of cSSTIs for clinical and research purposes, thorough and updated epidemiological data on cSSTIs and methicillin-resistant Staphylococcus aureus in the region, clearcut indications of novel agents and comprehensive assessment of comparative data should be factored into decision-making are necessary.
ABSTRACT
Objectives: The objectives of this study were to determine the frequency of methicillin-resistant Staphylococcus aureus [MRSA] colonization or infection while on admission to the intensive care unit [ICU], and examine the genetic backgrounds of the MRSA isolates to establish transmission among the patients
Subjects and Methods: This study involved screening 2,429 patients admitted to the ICU of Farwania Hospital from January 2005 to October 2007 for MRSA colonization or infection. The MRSA isolates acquired after admission were investigated using a combination of molecular typing techniques to determine their genetic backgrounds
Results: Of 2,429 patients screened, 25 [1.0%] acquired MRSA after admission to the ICU. Of the 25 MRSA, 19 [76%] isolates belonged to health care-associated [HA-MRSA] clones: ST239-III [n = 17, 68%] and ST22-IV [n = 2, 8%]. The remaining 6 MRSA isolates belonged to community-associated clones: ST80-IV [n = 3, 12%], ST97-IV [n = 2, 8%], and ST5-IV [n = 1, 4%]. The ST239-III-MRSA clone was associated with infection as well as colonization, and was isolated from patients from 2005 to 2007
Conclusions: The HA-MRSA clone ST239-III persistently colonized patients admitted to the ICU, indicating the possibility of its transmission among the patients over time
ABSTRACT
A 43-year-old woman presented to the surgical emergency department with acute abdominal pain associated with nausea, vomiting, constipation, fever and dysuria. Exploratory laparotomy was performed based on clinical diagnosis of acute appendicitis. Post-laparotomy, the diagnosis of pelvic disease [PID], left tuboovarian abscess and peritonitis due to Neisseria gonorrhoeae was made. The patient responded well to antibiotics and surgical management but was lost to follow-up