Epidemiology, microbiology, and antibiotic susceptibility patterns of skin and soft tissue infections, Joint Base San Antonio-Lackland, Texas, 2012-2014

Skin and soft tissue infections (SSTIs), including those caused by methicillin-resistant Staphylococcus aureus (MRSA), are common in military training environments. In 2014, the healthcare providers for trainees at Joint Base San Antonio (JBSA)-Lackland, TX, notified the surveillance unit of increased antibiotic resistance reported on wound cultures of purulent SSTIs. To provide updated clinical guidance to local providers, the surveillance unit conducted a review of all SSTIs diagnosed among trainees at JBSA-Lackland between 1 October 2012 and 31 December 2014. SSTI cumulative incidence during the surveillance period was 0.81%, with similar rates between males (0.80%) and females (0.84%) and between basic (0.82%) and technical (0.79%) trainees. Of 772 total cases, 254 were cultured; 196 resulted in growth of one or more pathogens: MRSA (n=110); methicillin-sensitive S. aureus (n=68); other gram-positive cocci (n=5); and gram-negative rods (n=18). In vitro activity of commonly used antibiotics against S. aureus isolates dropped slightly from the previous surveillance period. In addition to novel antibiotic research and development, these trends warrant enhanced local preventive efforts and close adherence to evidence-based treatment algorithms.