Staphylococci in primary skin and soft tissue infections in a Swedish county

Abstract

Patients with skin and soft tissue infections (SSTI) are frequently encountered in primary health care. The majority are uncomplicated and treated empirically by surgical incision and drainage and/or antibiotics. This strategy may risk delaying the detection of methicillin-resistant Staphylococcus aureus (MRSA), which, although still rare in Sweden, is increasingly being found in patients with SSTI. To avoid ‘late detection’ of MRSA, primary health care physicians in Kronoberg county, Sweden, were asked to perform a culture as soon as the patient's first visit. Samples from 175 patients with primary SSTI confirmed that S. aureus is the dominant pathogen. Two cases of MRSA were detected. Furthermore, isolates of S. aureus producing the Panton-Valentine leukocidin (PVL) toxin were more common among isolates from SSTI than among S. aureus from secondary infections. Finally, we confirmed the importance of the coagulase-negative staphylococcal species S. lugdunensis as a pathogen as it was isolated as the only pathogen in 10% of the skin and soft tissue samples.