Methicillin-resistant Staphylococcus aureus (MRSA) in perianal abscesses represents an underrecognized condition.
It is unclear whether these abscesses differ in presentation or other characteristics from their non-MRSA counterparts.
Dr Jeffrey Albrightand colleagues from USA retrospectively assessed patients diagnosed with perianal abscess, who underwent incision and drainage between 2003 and 2005.
The investigative team collected demographics, abscess characteristics, presence of MRSA on culture, MRSA susceptibilities, and clinical course.
|MRSA was present in 35% of cases|
|Diseases of the Colon & Rectum|
The team found a total of 104 patients, of which 63% were male with a mean age of 43 years were treated for perianal abscess.
For the 69 patients cultured at drainage, MRSA was present in 35% of cases.
MRSA-positive patients did not differ from MRSA-negative patients with respect to age, MRSA risk factors, duration of symptoms, white blood cell count at admission, or length of stay.
Patients were more likely to be MRSA-positive if they possessed extensive induration, extensive erythema, or small amount of purulence.
The team observed that ischiorectal abscesses were significantly less likely to be MRSA-positive.
The investigators observed that no patients with MRSA-positive abscesses developed fistulas.
In addition, the team noted that all MRSA isolates were resistant to ß-lactam antibiotics and had limited susceptibility to quinolones.
Dr Albright's team concluded, "The prevalence of MRSA in perianal abscesses has not been described previously and is higher in our group of patients than would be expected."
"MRSA-positive patients cannot be identified by risk factors alone."
"Antibiotic resistance spectra of MRSA vary from that of enteric bacteria typically seen in perianal abscesses."
"Therefore, it may be beneficial to culture all perianal abscesses with extensive induration and erythema or minimal purulence."