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Premier’s MRSA Experts Educate Shareholders
November 1, 2009
Tom Syzek and Alex Cook are the local experts….on MRSA that is! At September’s shareholders’ meeting, they presented a one CME hour presentation on Community Acquired MRSA and Perispinal Abscess. Ten to fifteen years ago MRSA (methicillin resistant Staph aureus) infection was limited to hospitals and nursing homes. It is now the most commonly diagnosed bacterial infection causing folliculitis and abscesses. “Nobody has more experience at incision and drainage of these things than the emergency physicians and PAs” says Dr. Syzek, Director of Risk management.
“It looks and acts a lot like a spider bite—except without the spider,” says Alex Cook, PA-C. Patients often assume that the small pustule is the result of a sneaky insect that escaped unseen, but when the pustule becomes large, red, and painful, many are eager to seek care. “The treatment is surgical,” says Cook. “All the antibiotics in the world will not cure a fluctuant abscess.” Although the literature suggests that antibiotics may not be necessary after I&D, Syzek and Cook recommend treating with Bactrim or Clindamycin because the recurrence rate is high. Many people are colonized by the bacteria in their nasopharynx and elsewhere on the body. If they have a previous infection with MRSA, and the source of the bacteria is not addressed they can easily be reinfected.
Perispinal abscess is another site that MRSA can affect, and it is more difficult to diagnose. “You must maintain a high level of suspicion for patients with fever and back or neck pain, especially in high risk patients, including those who are diabetic, immunocompromised, or have had a change in their pattern of chronic back pain,” says Dr. Syzek. “MRI is the test of choice for this condition, but that test is not always available for emergency department patients. Think about doing a sedimentation rate as part of your diagnostic panel. The bottom line is that if you suspect this condition, you have to aggressively look for it.”
The Risk Management Lecture Series is presented through the cooperation of the Risk Management and Education Divisions of PHCS. If you would like to review this power point presentation, go to the Education link on the intranet and click on Risk Management Lecture Series. A post-test will soon be posted for one free hour of CME.
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