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More MRSA Diagnoses Turning Up in Persistent Vaginal Yeast Infections


 

HOUSTON — Pustules and excoriations in conjunction with vaginal yeast infections are increasingly testing positive for methicillin-resistant Staphylococcus aureus infection, Dr. Sebastian Faro said at a conference on vulvovaginal diseases jointly sponsored by Baylor College of Medicine and the Methodist Hospital.

“Those of us in this area are seeing a lot more MRSA. It is important to be aware of it,” said Dr. Faro, clinical professor in obstetrics, gynecology, and reproductive sciences at the University of Texas, Houston.

He said the increasing number of vaginal infections with non-albicans strains of candidal yeast might play a role in this phenomenon, because they are resistant to regular antifungal treatments and can result in prolonged symptoms if not identified early.

“I strongly recommend culturing the yeast in all cases because if the patient has a non-albicans species, she will likely fail standard therapy,” he said in an interview. “Any of these patients can have excoriations, and so they are putting themselves at risk for secondary infection, such as MRSA.”

Dr. Faro said because 20% of the general population has chronic nasal colonization with MRSA and up to 40% or more will be transiently colonized, he has a high index of suspicion when he sees excoriations.

“If any excoriation seems to have a halo of erythema or is raised, or if there is a purulent exudate, I routinely culture it [as well as] the patient's nose,” he said. In patients with a positive MRSA culture, he recommends topical Bactroban cream or ointment, but if there are signs of cellulitis, he recommends oral minocycline 100 mg twice a day for 2 weeks.

Always culture because 'if the patient has a non-albicans species, she will likely fail standard therapy.' DR. FARO

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