Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl
Abstract Objective: Develop a Staphylococcus aureus wound antibiogram among patients who use fentanyl (PWUF) presenting with acute S. aureus skin and soft tissue infections (SSTIs) in Philadelphia, Pennsylvania. Design: Retrospective, multisite cohort study. Patients and Setting: Individuals p...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25000129/type/journal_article |
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| _version_ | 1823856579659694080 |
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| author | Drew T. Dickinson Stephen Saw Lauren Dutcher Christina Maguire Adrienne Terico Margaret Lowenstein Sonal Patel |
| author_facet | Drew T. Dickinson Stephen Saw Lauren Dutcher Christina Maguire Adrienne Terico Margaret Lowenstein Sonal Patel |
| author_sort | Drew T. Dickinson |
| collection | DOAJ |
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Abstract
Objective:
Develop a Staphylococcus aureus wound antibiogram among patients who use fentanyl (PWUF) presenting with acute S. aureus skin and soft tissue infections (SSTIs) in Philadelphia, Pennsylvania.
Design:
Retrospective, multisite cohort study.
Patients and Setting:
Individuals presenting to emergency departments or admitted to inpatient units of four Penn Medicine hospitals with an acute S. aureus SSTI and illicit fentanyl use within the previous year.
Methods:
We described susceptibilities of S. aureus isolated from wound cultures among the PWUF cohort and compared these to the health system’s wound antibiogram. We compared frequency of in-hospital medication treatment for opioid use disorder among patients who left the hospital prior to vs after the availability of S. aureus susceptibilities.
Results:
Among 131 S. aureus isolates from 131 PWUF, 35/131 (26.7%) were susceptible to oxacillin, 73/121 (60.3%) were susceptible to clindamycin, 77/122 (63.1%) were susceptible to tetracycline, and 119/126 (94.4%) were susceptible to trimethoprim-sulfamethoxazole. PWUF displayed significantly reduced susceptibility to oxacillin and tetracycline compared to the health system’s outpatient wound S. aureus antibiogram. Compared to patients discharged prior to susceptibility availability, more patients discharged after the reporting of susceptibilities were administered buprenorphine or methadone in the hospital (82.0% vs 51.4%, P < 0.001).
Conclusion:
High nonsusceptibility to clindamycin and tetracycline suggests these agents should not be prescribed as empiric therapy for acute S. aureus SSTI in PWUF in Philadelphia. PWUF would benefit from joint management by infectious diseases and addiction medicine experts to ensure prescription of active therapy. Additional study is needed of PWUF in other regions.
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| format | Article |
| id | doaj-art-535f69865e7441e49fc0bba52033eab0 |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-535f69865e7441e49fc0bba52033eab02025-02-12T07:09:17ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.12Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanylDrew T. Dickinson0https://orcid.org/0000-0001-8018-4070Stephen Saw1Lauren Dutcher2Christina Maguire3https://orcid.org/0000-0002-5590-2736Adrienne Terico4https://orcid.org/0000-0001-8647-786XMargaret Lowenstein5https://orcid.org/0000-0001-5450-6814Sonal Patel6Department of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, PA, USADepartment of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, PA, USADivision of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USADepartment of Pharmacy Services, Penn Presbyterian Medical Center, Philadelphia, PA, USADepartment of Pharmacy Services, Pennsylvania Hospital, Philadelphia, PA, USACenter for Addiction Medicine & Policy, University of Pennsylvania, Philadelphia, PA, USA Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USADepartment of Pharmacy Services, Hospital of the University of Pennsylvania, Philadelphia, PA, USA Abstract Objective: Develop a Staphylococcus aureus wound antibiogram among patients who use fentanyl (PWUF) presenting with acute S. aureus skin and soft tissue infections (SSTIs) in Philadelphia, Pennsylvania. Design: Retrospective, multisite cohort study. Patients and Setting: Individuals presenting to emergency departments or admitted to inpatient units of four Penn Medicine hospitals with an acute S. aureus SSTI and illicit fentanyl use within the previous year. Methods: We described susceptibilities of S. aureus isolated from wound cultures among the PWUF cohort and compared these to the health system’s wound antibiogram. We compared frequency of in-hospital medication treatment for opioid use disorder among patients who left the hospital prior to vs after the availability of S. aureus susceptibilities. Results: Among 131 S. aureus isolates from 131 PWUF, 35/131 (26.7%) were susceptible to oxacillin, 73/121 (60.3%) were susceptible to clindamycin, 77/122 (63.1%) were susceptible to tetracycline, and 119/126 (94.4%) were susceptible to trimethoprim-sulfamethoxazole. PWUF displayed significantly reduced susceptibility to oxacillin and tetracycline compared to the health system’s outpatient wound S. aureus antibiogram. Compared to patients discharged prior to susceptibility availability, more patients discharged after the reporting of susceptibilities were administered buprenorphine or methadone in the hospital (82.0% vs 51.4%, P < 0.001). Conclusion: High nonsusceptibility to clindamycin and tetracycline suggests these agents should not be prescribed as empiric therapy for acute S. aureus SSTI in PWUF in Philadelphia. PWUF would benefit from joint management by infectious diseases and addiction medicine experts to ensure prescription of active therapy. Additional study is needed of PWUF in other regions. https://www.cambridge.org/core/product/identifier/S2732494X25000129/type/journal_article |
| spellingShingle | Drew T. Dickinson Stephen Saw Lauren Dutcher Christina Maguire Adrienne Terico Margaret Lowenstein Sonal Patel Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| title_full | Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| title_fullStr | Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| title_full_unstemmed | Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| title_short | Staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| title_sort | staphylococcus aureus susceptibilities from wounds of patients who use illicit fentanyl |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25000129/type/journal_article |
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