Methicillin-resistant Staphylococcus aureus (MRSA) in an Austrian urological department: 10 years experience covering 95.161 patients.

PURPOSE: So far, few data is available on Methicillin-resistant Staphylococcus aureus (MRSA) infections in urology. To obtain a better insight into MRSA infections, we studied prevalence, colonization and infection site and clinical implications of MRSA in a urological department over a 10-year period. METHODS: A retrospective study of all patients diagnosed with MRSA for the first time over a 10-year period was set-up. RESULTS: Between 2000 and 2009, a total of 95.161 in- and outpatients were seen at our department. The prevalence of patients with newly diagnosed MRSA was low, that is, <0.1 % per year (mean 0.07%, 0.02-0.1 %). In total, 62 MRSA cases were identified over a 10-year period. MRSA incidence was 10 times higher in inpatients (0.2 %) than in outpatients (0.02 %). Asymptomatic MRSA colonization was present in 25/62 patients (40.3 %), the remaining 59.7 % (37/62) showed clinical symptoms: MRSA positive swabs from open wounds were seen in 10/62 patients (16.1 %). Urinary tract infections were seen in 26/10 patients (41.9 %), while life-threatening MRSA sepsis occurred in one patient only over a decade. CONCLUSIONS: In summary, we observed very low rates of MRSA colonization and infection. Still, complications like delayed wound healing, development of abscess and even sepsis may occur.

Gemella morbillorum bacteremia after anti-tumor necrosis factor alpha as acne inversa therapy.

We present a case of fever, brain abscesses, and Gemella morbillorum bacteremia after anti-tumor necrosis factor alpha (TNF-α) therapy in a 21-year-old acne inversa patient currently taking long-term dapsone. To the best of our knowledge, this is the first report describing such a case. During antimicrobial therapy, the patient developed systemic varicella infection with severe thrombocytopenia.