This case will help you managing the community acquired coetaneous MRSA wounds and antibiotics choice plus animal bites pathology and management

25.  Methicillin resistance in S. aureus is defined as an Oxacillin (MIC) > 4
microgram/mL. Isolates resistant to oxacillin or methicillin are also
resistant to all beta - lactam agents including cephalosporins.

27.  The mecA gene responsible for methicillin resistance
 Staphylococcal cassette chromosome (SCCmec).
 There are five SCCmec types (I-V) that vary in genetic
makeup and size.

28. Hospital Associated Community Associated
MRSA MRSA
HA - MRSA CA - MRSA
type I, II, or III SCCmec type IV SCCmec
does not carry the multiple antibiotic
resistance
Sensitive to Bactrim, Clindamycin &
Multiple antibiotic resistance 50% fluoroquinolones.
Panton-Valentine leukocidin
•SCCmec type IV CA-MRSA
•skin
•soft tissue
•necrotizing pneumonia
Prolonged hospitalization •MRSA USA300

29. 12-29%

30.  Prior skin infection
 Previous antibiotic use
 Illicit drug use
 Tattoo recipients
 Prison residence
 Military personnel
 A higher body mass index
 Cosmetic body shaving
 Physical contact with a person who has
a draining lesion or is a carrier of MRSA
 Sharing equipment that is not cleaned
or laundered between users

31.  Antibiotic use within three months before admission.
 Hospitalization during the past 12 months.
 Diagnosis of skin or soft-tissue infection at admission
 HIV infection

32.  Skin or soft tissue infections.
 Necrotizing pneumonia.
 Necrotizing fasciitis
 Rapidly fatal septicemia
 Endocarditis
 Osteomyelitis