Annals of Emergency Medicine
Volume 50, Issue 1 , Pages 64-66 , July 2007

Skin and Soft Tissue Abscesses: The Case for Culturing Abscess Fluid

References 

  1. Swartz MN. Cellulitis. N Engl J Med. 2004;350:904–912
  2. Centers for Disease Control and Prevention. Outbreaks of community-associated methicillin-resistant Staphylococcal aureus skin infections—Los Angeles County, California 2002-03. MMWR Morb Mortal Wkly Rep. 2003;52:88
  3. Frazee BW, Lynn J, Charlebois ED, et al. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med. 2005;45:311–320
  4. Moran GJ, Amii RN, Abrahamian F, et al. Methicillin-resistant Staphylococcus aureus in community-acquired skin infections. Emerg Infect Dis. 2005;11:928–930
  5. Moran GJ, Krishnadasan A, Gorwitz RJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006;355:666–674
  6. Gonzalez BE, Martinez-Aguilar G, Hulten KG, et al. Severe staphylococcal sepsis in adolescents in the era of community-acquired methicillin-resistant Staphylococcus aureus. Pediatrics. 2005;115:642–648
  7. Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976–2984
  8. Deresinki S. Methicillin-resistant Staphylococcus aureus: an evolutionary, epidemiologic, and therapeutic odyssey. Clin Infect Dis. 2005;40:562–573
  9. Kowalski TJ, Berbari EF, Osmon DR. Epidemiology, treatment and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections. Mayo Clinic Proc. 2005;80:1201–1208
  10. Lina G, Piemont Y, Godail-Gamot F, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999;29:1128–1132
  11. Francis JS, Doherty MC, Lopatin U, et al. Severe community-onset pneumonia in healthy adults caused by methicillin-resistant Staphylococcus aureus carrying the Panton-Valentine leukocidin genes. Clin Infect Dis. 2005;40:100–107
  12. Buck JM, Como-Sabetti K, Harriman KH, et al. Community-associated methicillin-resistant Staphylococcus aureus, Minnesota 2002-2003. Emerg Infect Dis. 2005;11:1532–1538
  13. Chavez-Bueno S, Bozdogan B, Katz K, et al. Inducible clindamycin resistance and molecular epidemiologic trends of pediatric community-acquired methicillin-resistant Staphylococcus aureus in Dallas, Texas. Antimicrob Agents Chemother. 2005;49:2283–2288
  14. Fiebelkorn KR, Crawford SA, McElmeel ML, et al. Practical disk diffusion method for detection of inducible clindamycin resistance in Staphylococcus aureus and coagulase negative staphylococci. J Clin Microbiol. 2003;41:4740–4744

 Funding and support: The author reports this study did not receive any outside funding or support and there were no other conflicts of interest to declare. See the Manuscript Submission agreement form, published each month, for details of covered relationships.Editor’s note: The treatment of superficial skin abscesses has recently been complicated by the emergence of community-associated methicillin-resistant Staphylococcus aureus (community-associated MRSA), a pathogen that is frequently resistant to the antibiotics that are usually used to treat skin infections. Although routine wound cultures can help identify the presence of this pathogen and reveal any unique or unusual antimicrobial susceptibilities, the clinical utility of information obtained from routine wound cultures is unclear: the majority of these lesions can be adequately treated using simple incision and drainage, and identification of the organism and its susceptibility patterns is irrelevant.In this installment of Clinical Controversies, “pro” and “con” advocates discuss opposing perspectives and present the available evidence and arguments that must be considered in deciding to embrace or abandon the use of routine wound cultures in treating patients who present with superficial skin abscesses.

PII: S0196-0644(07)00385-X

doi: 10.1016/j.annemergmed.2007.03.024

Annals of Emergency Medicine
Volume 50, Issue 1 , Pages 64-66 , July 2007

Article Tools