Community Associated Methicillin Resistant Staphylococcus Aureus Causing Fournier’s Gangrene and Genital Infections

Purpose

We identified an emerging infectious disease of the genitoperineum caused by community associated, methicillin resistant Staphylococcus aureus.

Materials and Methods

We report our experience with severe genital infections caused by community associated, methicillin resistant S. aureus occurring in 3 individuals who lacked any of the risk factors associated with traditional methicillin resistant S. aureus infection. Two cases were limited to scrotal abscesses that required only incision and drainage plus antimicrobial therapy. To our knowledge the third case represents the first and only reported case to date of Fournier’s gangrene caused by community associated, methicillin resistant S. aureus.

Results

The prevalence of community associated, methicillin resistant S. aureus complicated skin and skin structure infections is increasing throughout the United States and other countries. Community associated, methicillin resistant S. aureus contains unique virulence factors but retains sensitivity to various nonβ-lactam antibiotics. Historical risk factors associated with methicillin resistant S. aureus appear not to apply to infections associated with community associated, methicillin resistant S. aureus. Infections due to the latter cause have been identified in healthy individuals of all ages, races and ethnicities. Surgical and antimicrobial approaches to management are presented.

Conclusions

Community associated, methicillin resistant S. aureus infections of the genitoperineum are likely to increase in incidence, necessitating heightened awareness on the part of the urologist.

Key Words: scrotum, testes, fasciitis, necrotizing, Fournier gangrene, Staphylococcus aureus

Abbreviations and Acronyms: CA-MRSA, community associated MRSA, CSSTI, complicated skin and skin structure infection, HA-MRSA, hospital associated MRSA, MRSA, methicillin resistant Staphylococcus aureus, TMP/SMX, trimethoprim/sulfamethoxazole