UCLA researchers issue guidelines on the treatment and management of MRSA skin abscesses
It has been more than 10 years since the clinical battle began with community-acquired methicillin-resistant Staphylococcus aureus (MRSA), and doctors are still grappling with how to diagnose, treat and prevent this virulent form of staph infection, which is immune to many antibiotics.
Credits: CDC/Janice Carr
As MRSA cases have increased dramatically over the decade, so have the number of skin abscesses — generally pus-filled boils or pimples with discharge — that characterize these infections. Now, researchers from UCLA have issued updated guidelines outlining the best ways to treat and manage these abscesses.
The first cases of MRSA were relatively mild and primarily affected high-risk patients in hospitals and long-term care facilities. But beginning the early 2000s, doctors identified a new, highly contagious and hard-to-treat strain known as “community-acquired” MRSA, which had spread to the general public. This more virulent form of the infection can be dangerous and in severe cases cause necrotizing pneumonia, fasciitis and sepsis.
One of the first reports that MRSA infections would become epidemic was published in the New England Journal of Medicine in 2006 by Dr. Gregory Moran, Dr. David A. Talan and colleagues at Olive View–UCLA Medical Center.
Their research showed that community-associated MRSA had become the most common cause of skin infection among patients presenting at emergency departments and other settings in the U.S.
In a new report published March 13 in the New England Journal of Medicine, Talan and Dr. Adam J. Singer of the emergency medicine department at Stony Brook University in New York present updated “best practice” guidelines for managing the skin abscesses associated with community-acquired MRSA.
“MRSA is not going away, so we need to fine-tune ways to treat it,” said Talan, a professor in the division of infectious diseases and chief of the department of emergency medicine at Olive View–UCLA Medical Center. “We hope the information will help guide doctors as to the best ways to address these infection-related skin abscesses.”
For the article, Talan and Singer, both of whom are on the front lines of treating MRSA, focused on abscesses that occur on the trunk of the body and the extremities, like the arms and legs, which are often treated by general practitioners or emergency room physicians. An abscess is a collection of pus that has accumulated within tissue because of the inflammatory process in response infections like MRSA.
The doctors reviewed prior studies and provided their expert opinions. Highlights of their clinical update include an emphasis on new diagnostic techniques such as ultrasound, guidance for doctors on the most effective antibiotics, and an overview of abscess-draining techniques that are less invasive, painful and disfiguring than conventional methods.
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