open access

Vol 58, No 1-4 (2007)
MARITIME HEALTH
Submitted: 2013-02-18
Published online: 2010-03-26
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Suspected Methicillin-resistant Staphylococcus aureus infections at sea

Raymond Lucas, Keith Boniface, Karen Roberts, Elisabeth Kane
International Maritime Health 2007;58(1-4):93-102.

open access

Vol 58, No 1-4 (2007)
MARITIME HEALTH
Submitted: 2013-02-18
Published online: 2010-03-26

Abstract

Background: Methicillin-resistant Staphylococcus aureues (MRSA) has been increasingly reported as the cause of community acquired skin infections in individuals without established risk factors. MRSA infections have been reported in multiple settings, but not yet in the commercial maritime industry.
Objective: To evaluate the incidence of skin and soft tissue infections at sea over the past 5 years, and to see if there are trends in reported clinical features that suggest MRSA as the pathogen.
Methods: A retrospective chart review was undertaken of all cases reported from 2002 until 2006 to a single tele-medical advice service for ships at sea. Since microbiologic diagnosis is not feasible at sea, cases were evaluated for the following features which may suggest MRSA: the presence of pus, small abscess or furuncle, or suspected spider bite.
Results: From 2002 to 2006 the percentage of cases that were skin infections rose from 5.5 to 8.8%. In 2002, 36% had features consistent with MRSA infection and 74 % had them in 2006 ( p <.05). Across all years approximately 25% of cases required an I&D procedure at sea or upon arrival in port.
Conclusions: The number of skin infections reported to a single tele-medical advice service has increased in the past five years. Furthermore, the proportion of cases with features common to MRSA infections doubled. Planners for health care at sea should consider stocking appropriate antibiotics for suspected MRSA and ensure medical officers are trained to perform I&D (incision and drainage) in order to treat this increasingly common skin infection.

Abstract

Background: Methicillin-resistant Staphylococcus aureues (MRSA) has been increasingly reported as the cause of community acquired skin infections in individuals without established risk factors. MRSA infections have been reported in multiple settings, but not yet in the commercial maritime industry.
Objective: To evaluate the incidence of skin and soft tissue infections at sea over the past 5 years, and to see if there are trends in reported clinical features that suggest MRSA as the pathogen.
Methods: A retrospective chart review was undertaken of all cases reported from 2002 until 2006 to a single tele-medical advice service for ships at sea. Since microbiologic diagnosis is not feasible at sea, cases were evaluated for the following features which may suggest MRSA: the presence of pus, small abscess or furuncle, or suspected spider bite.
Results: From 2002 to 2006 the percentage of cases that were skin infections rose from 5.5 to 8.8%. In 2002, 36% had features consistent with MRSA infection and 74 % had them in 2006 ( p <.05). Across all years approximately 25% of cases required an I&D procedure at sea or upon arrival in port.
Conclusions: The number of skin infections reported to a single tele-medical advice service has increased in the past five years. Furthermore, the proportion of cases with features common to MRSA infections doubled. Planners for health care at sea should consider stocking appropriate antibiotics for suspected MRSA and ensure medical officers are trained to perform I&D (incision and drainage) in order to treat this increasingly common skin infection.
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About this article
Title

Suspected Methicillin-resistant Staphylococcus aureus infections at sea

Journal

International Maritime Health

Issue

Vol 58, No 1-4 (2007)

Pages

93-102

Published online

2010-03-26

Bibliographic record

International Maritime Health 2007;58(1-4):93-102.

Authors

Raymond Lucas
Keith Boniface
Karen Roberts
Elisabeth Kane

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