RESUMO
BACKGROUND: Skin and soft tissue infections (SSTIs) are commonly caused by group A Streptococcus (GAS). Rapid molecular assays for detecting GAS in wounds would help with clinical management. This study assessed a point-of-care system for the detection of GAS in non-severe SSTIs in a Native American community in the Southwest. METHODS: Patients presenting with a new non-severe SSTI were eligible if a swab was collected. The swab was tested by traditional culture methods and using the cobas® Liat® point-of-care (POC) system and results were compared. RESULTS: 399 samples were included. The final result from the POC assay was positive for 52.0% of samples. Compared to culture, the POC assay had a sensitivity of 100% and specificity of 99.5%. CONCLUSIONS: The cobas® Liat® system accurately and efficiently identified GAS in non-severe SSTIs. Having a POC test available to rapidly identify or rule out GAS could help to minimize overuse of antibiotics.
Assuntos
Infecções dos Tecidos Moles , Humanos , Patologia Molecular , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade , Infecções dos Tecidos Moles/diagnóstico , Streptococcus pyogenes/genéticaRESUMO
BACKGROUND: This study was done to determine the burden of invasive Staphylococcus aureus on the White Mountain Apache Tribal lands. METHODS: Active population and laboratory-based surveillance for invasive S aureus infections was conducted from May 2016 to April 2018. A case was defined as a Native American individual living on or around the White Mountain Apache Tribal lands with S aureus isolated from a normally sterile body site. RESULTS: Fifty-three cases were identified. Most cases were adults (90.6%) and hadâ ≥1 underlying medical condition (86.8%), the most common of which were diabetes (49.1%) and obesity (41.5%). A total of 26.4% cases were categorized as community acquired. Most infections were methicillin-resistant (75.5%). A total of 7.5% of cases required amputation, and 7.7% of cases died within 30 days of initial culture. The incidence of invasive S aureus was 156.3 per 100â 000 persons. The age-adjusted incidence of invasive methicillin-resistant S aureus was 138.2 per 100â 000 persons. CONCLUSIONS: This community has a disproportionately high burden of invasive methicillin-resistant S aureus compared with the general US population. Interventions are urgently needed to reduce the morbidity and mortality associated with these infections.