TY - JOUR
T1 - Increasing incidence of iliopsoas abscesses with MRSA as a predominant pathogen
AU - Alonso, Carolyn D.
AU - Barclay, Sam
AU - Tao, Xuguang
AU - Auwaerter, Paul G.
N1 - Funding Information:
The authors would like to acknowledge Richard Moore M.D. for his assistance with the Case Mix System and Paul Allen for providing the institutional hospitalization rates. This work was supported by grant T32 AI007291 from the National Institute of Allergy and Infectious Diseases (CDA) . Presented in part at the 48th Annual Meeting of the Infectious Diseases Society of America (IDSA), Vancouver, British Columbia, Canada, October 21–24, 2010 (Abstract 2574).
PY - 2011/7
Y1 - 2011/7
N2 - Objectives: Iliopsoas abscesses (IPAs) are rare infections involving purulence within the muscles of the iliopsoas compartment, seldom due to Methicillin-resistant Staphylococcus aureus (MRSA) historically. This study was designed to evaluate the clinical characteristics and outcomes of patients with IPAs. Methods: A retrospective analysis of the demographics, clinical presentation, microbiologic data and treatment modalities among patients with IPAs from 1993 to 2007 at The Johns Hopkins Hospital was performed. Results: Among 61 patients with IPAs, infection rates increased from 0.5 cases/10,000 admissions (1993-2004) to 6.5 cases/10,000 admissions (2005-2007) (P < 0.001). An adjacent infectious focus was identified in 80% of patients, from skeletal (48%), intra-abdominal (23%), vascular (5%), genitourinary (3%), and cutaneous sources (2%). During 2005-2007, MRSA became a predominant pathogen, accounting for 25% of all cases and 37% of cases with a definitive microbiologic diagnosis (P = 0.006). Patients with IPAs >2 cm were more likely to undergo drainage, with trends toward longer hospitalizations, longer antibiotic courses, and increased odds of securing a definitive microbiologic diagnosis. Conclusions: Since 2005, rates of IPA have dramatically increased, with MRSA now the leading cause of infection. Knowledge of common pathogens should guide antimicrobial therapy including empiric coverage for MRSA in institutions with similar populations, especially if culture data are not available.
AB - Objectives: Iliopsoas abscesses (IPAs) are rare infections involving purulence within the muscles of the iliopsoas compartment, seldom due to Methicillin-resistant Staphylococcus aureus (MRSA) historically. This study was designed to evaluate the clinical characteristics and outcomes of patients with IPAs. Methods: A retrospective analysis of the demographics, clinical presentation, microbiologic data and treatment modalities among patients with IPAs from 1993 to 2007 at The Johns Hopkins Hospital was performed. Results: Among 61 patients with IPAs, infection rates increased from 0.5 cases/10,000 admissions (1993-2004) to 6.5 cases/10,000 admissions (2005-2007) (P < 0.001). An adjacent infectious focus was identified in 80% of patients, from skeletal (48%), intra-abdominal (23%), vascular (5%), genitourinary (3%), and cutaneous sources (2%). During 2005-2007, MRSA became a predominant pathogen, accounting for 25% of all cases and 37% of cases with a definitive microbiologic diagnosis (P = 0.006). Patients with IPAs >2 cm were more likely to undergo drainage, with trends toward longer hospitalizations, longer antibiotic courses, and increased odds of securing a definitive microbiologic diagnosis. Conclusions: Since 2005, rates of IPA have dramatically increased, with MRSA now the leading cause of infection. Knowledge of common pathogens should guide antimicrobial therapy including empiric coverage for MRSA in institutions with similar populations, especially if culture data are not available.
KW - Iliopsoas abscess
KW - MRSA
KW - Psoas abscess
KW - Pyomyositis
KW - Staphylococcus aureus
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U2 - 10.1016/j.jinf.2011.05.008
DO - 10.1016/j.jinf.2011.05.008
M3 - Article
C2 - 21641042
AN - SCOPUS:79959610371
SN - 0163-4453
VL - 63
SP - 1
EP - 7
JO - Journal of Infection
JF - Journal of Infection
IS - 1
ER -