Predictors of community-associated Staphylococcus aureus, methicillin-resistant and methicillin-susceptible Staphylococcus aureus skin and soft tissue infections in primary-care settings.

Skin and soft tissue infections (SSTIs) due to Staphylococcus aureus have become increasingly common in the outpatient setting; however, risk factors for differentiating methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) SSTIs are needed to better inform antibiotic treatment decisions. We performed a case-case-control study within 14 primary-care clinics in South Texas from 2007 to 2015. Overall, 325 patients [S. aureus SSTI cases (case group 1, n = 175); MRSA SSTI cases (case group 2, n = 115); MSSA SSTI cases (case group 3, n = 60); uninfected control group (control, n = 150)] were evaluated. Each case group was compared to the control group, and then qualitatively contrasted to identify unique risk factors associated with S. aureus, MRSA, and MSSA SSTIs. Overall, prior SSTIs [adjusted odds ratio (aOR) 7·60, 95% confidence interval (CI) 3·31-17·45], male gender (aOR 1·74, 95% CI 1·06-2·85), and absence of healthcare occupation status (aOR 0·14, 95% CI 0·03-0·68) were independently associated with S. aureus SSTIs. The only unique risk factor for community-associated (CA)-MRSA SSTIs was a high body weight (⩾110 kg) (aOR 2·03, 95% CI 1·01-4·09).

Two rapid urine screens for detection of bacteriuria: an evaluation.

Five hundred twenty-five random clean catch urine specimens, collected from 339 adult females, 137 adult males, and 49 pediatric patients, were screened for the presence of bacteriuria with the Uriscreen catalase test and with the Chemstrip 2 LN dipstick. Quantitative cultures were performed on all specimens. The sensitivity, specificity, positive predictive value, and negative predictive value for the catalase test, with 10(5) CFU/ml as the threshold for significant bacteriuria, were 91.3%, 72.3%, 33.7%, and 98.0%, respectively. Values for the dipstick were 83.9%, 77.9%, 43.7%, and 96.0%. When 10(4) CFU/ml was used as the threshold, the catalase test had a sensitivity of 89.2%, specificity of 70.4%, positive predictive value of 37.3%, and a negative predictive value of 97.0%. Values for the dipstick at that level were 82.3%, 77.5%, 48.6%, and 94.8%. While the catalase test was more sensitive than the dipstick, it was our opinion that high rates of false-negatives associated with these methods negated the convenience of these fast and simple urine screens.

Effect of povidone-iodine irrigation on the preoperative chemical preparation of the eye.

Preoperative eyes which had been treated with gentamicin for one-half day were subjected to one of two povidone-iodine (PI) preparations. The control eye was prepared using a previously described 5% PI one-drop technique, while the paired eye was irrigated with a 0.02% PI solution. Aerobic and anaerobic bacterial cultures were taken of each eye before and after PI applications. Statistical analysis of the data indicates that both techniques were equally effective in reducing surface colonization of the anaerobic cocci and bacilli, the viridans streptococci and micrococci. Both methods were also equally ineffective in reducing the numbers of coagulase-negative staphylococci from the surface of the eye. With the apparent emergence of gentamicin-resistant coagulase-negative staphylococci the potential for staphylococcal endophthalmitis is increasing.