ESCAPED: Emerging Staphylococcus aureus Resistance and Current Antimicrobial Patterns in Emergency Departments
Emerging S. aureus Antimicrobial Resistance and Current Prescribing Practices for Patients Presenting to US Emergency Departments with a Purulent Skin and Soft Tissue Infection
Project Purpose
We propose to conduct a multicenter, prospective, observational project aimed at describing antimicrobial resistance of S. aureus and prescribing patterns for the management of purulent skin and soft tissue infections (SSTIs) in an emergency department (ED) setting. SSTIs have become a more common presentation in EDs after methicillin-resistant S. aureus (MRSA) became the predominant causative agent over the last two decades. Recent literature suggests a potential emergence in antimicrobial resistance by S. aureus to commonly prescribed antibiotics, but is limited to inpatient and retrospective observational studies. A multicenter investigation through EMERGEncy ID NET, a network of 12 US EDs, will inform the current prevalence of MRSA, antimicrobial resistance patterns, and practices regarding empiric antimicrobial prescribing and culture/susceptibility testing in the United States.
Project Design
Patients of any age presenting with a purulent SSTI will be consented and enrolled in the ED. During the ED visit, the site coordinator will record responses from the participant and their treating clinician about the participant’s illness and obtain a swab of the purulent material. The site coordinator will contact the participant at 30 days to ask them about the outcome of their illness, antimicrobial therapy, and healthcare utilization. Site coordinators will conduct an EMR review to obtain information about the ED visit, baseline lab results, prior S. aureus skin infections in past year, and health care utilization through 30 days.
Participant Population
The project will enroll ED patients of any age who present for evaluation of a purulent SSTI of duration 7 days or less. This approach will allow inclusion of broad populations, including women, children, homeless, immigrants, and minorities.
Duration of Participant’s Participation
The duration of participation is 30 days but the actual project-related time spent by the participant will be about 20-40 minutes.
Duration of Project Enrollment
The project will begin in August 2024 and will continue for a minimum of six months.