Prevalence of methicillin-resistant Staphylococcus aureus in common pyodermas: A cross-sectional study at Fazaia Medical affiliated teaching hospital Islamabad
DOI:
https://doi.org/10.61529/idjp.v35i2.395Abstract
Background: Pyodermas are purulent skin infections involving the epidermis, dermis, or hair follicles. Staphylococcus aureus is the predominant causative agent, with methicillin-resistant Staphylococcus aureus (MRSA) becoming an increasing concern in both hospital and community settings. The aim of the study was to determine the prevalence of MRSA in common pyoderma cases.
Material and Methods: This descriptive cross-sectional study was conducted over six months in the Dermatology Department of Fazaia Medical Affiliated Teaching Hospital, Islamabad. A total of 150 patients with pyodermas were enrolled through non-probability consecutive sampling. Clinical data were recorded, and pus specimens were collected using sterile swabs after saline cleansing. Cultures were performed on nutrient agar, Mannitol salt agar, blood agar, and MacConkey agar. MRSA detection was carried out using the Kirby-Bauer disc diffusion method with Mueller-Hinton agar using cefoxitin discs according to CLSI guidelines.
Results: The mean patient age was 30.58 ± 17.44 years, with 91 (60.67%) males and 59 (39.33%) females. Furuncle (32.67%) and folliculitis (28.67%) were the most common diagnoses. MRSA was isolated in 53 (35.33%) patients. MRSA prevalence was significantly higher in secondary pyodermas (66.7%) versus primary pyodermas (21.9%) (p<0.001), in patients with symptoms >10 weeks (66.7%) versus ≤10 weeks (29.4%) (p<0.001), and in those with fewer lesions (41.7%) compared to those with more lesions (10%) (p=0.001).
Conclusion: The 35.33% MRSA prevalence aligns with other regional studies. The higher detection in secondary and chronic pyodermas highlights its clinical importance.
Keywords: Antimicrobial resistance, Community-acquired infections, Methicillin-resistant Staphylococcus aureus, Pyoderma, Skin infections
References
Bhat YJ, Hassan I, Bashir S, Farhana A, Maroof P. Clinico-bacteriological profile of primary pyodermas in Kashmir: a hospital-based study. J R Coll Physicians Edinb. 2016;46(1):8–13. DOI: https://doi.org/10.4997/jrcpe.2016.103
Ghimire RB, Pokharel K, Shrestha S. Prevalence of community-acquired pyoderma in dermatology outpatient department of a tertiary care hospital. J Nepal Med Assoc. 2019; 57(217): 178–81. DOI: https://doi.org/10.31729/jnma.4430
Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG Jr. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015; 28(3): 603–61. DOI: https://doi.org/10.1128/cmr.00134-14
Lakhundi S, Zhang K. Methicillin-resistant Staphylococcus aureus: Molecular characterization, evolution, and epidemiology. Clin Microbiol Rev. 2018; 31(4): e00020-18. DOI: https://doi.org/10.1128/cmr.00020-18
Siddiqui AH, Koirala J. Methicillin-resistant Staphylococcus aureus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 [cited 2026 Jun 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482221/
Bassetti M, Nicco E, Mikulska M. Why is community-associated MRSA spreading across the world and how will it change clinical practice? Int J Antimicrob Agents. 2009; 34(Suppl 1): S15–9. DOI: https://doi.org/10.1016/s0924-8579(09)70544-8
Tacconelli E, Magrini N, Kahlmeter G, Singh N. Global priority list of antibiotic-resistant bacteria [Internet]. Geneva: World Health Organization; 2017 [cited 2026 Jun 25]. Available from: https://www.who.int/publications/i/item/WHO-EMP-IAU-2017.12
Ullah A, Qasim M, Rahman H, Khan J, Haroon M, Muhammad N, et al. High frequency of MRSA in Peshawar region of Pakistan. Springer Plus. 2016; 5: 600. DOI: https://doi.org/10.1186/s40064-016-2277-3
Khan TM, Kok YL, Bukhsh A, Lee LH, Chan KG, Goh BH. Incidence of MRSA: A systematic review. Germs. 2018; 8(3): 113–25. DOI: https://doi.org/10.18683/germs.2018.1138
Jamil S, Khan MA, Ahmad Z, Ali S, Syed IA. Antibiotic susceptibility pattern and prevalence of Staphylococcus aureus from patients specimens at Ayub Medical Complex Abbottabad, Pakistan. Pure Appl Biol. 2020;9(1):269-74. doi:10.19045/bspab.2020.90031.
Muneer K, Ayub S, Aqeel J, Jaffer S, Ayub T, Maqsood S, et al. Frequency of MRSA in tertiary care hospital Lahore. Prof Med J. 2020; 27(3): 576–80. DOI: https://doi.org/10.29309/TPMJ/2020.27.03.3678
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing. 31st ed. CLSI supplement M100 [Internet]. Wayne (PA): CLSI; 2021 [cited 2026 Jun 25]. Available from: https://clsi.org/standards/products/microbiology/documents/m100/
Thomas N, Girisha BS. Bacteriological study of community-acquired pyoderma. Clin Dermatol Rev. 2018; 2(1): 13–8. DOI: https://doi.org/10.4103/CDR.CDR_21_17
Nagaraju U, Raju BP. MRSA in community-acquired pyoderma in children. Indian J Paediatr Dermatol. 2017; 18(1): 14–9. DOI: https://doi.org/10.4103/2319-7250.188425
Habib A, Qadir A. Frequency and antibiotic susceptibility pattern of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in uncomplicated skin and soft tissue infections. J Coll Physicians Surg Pak. 2022;32(11):1398-1402. doi:10.29271/jcpsp.2022.11.1398.
Clebak KT, Malone MA. Skin infections. Prim Care. 2018; 45(3): 433–54. DOI: https://doi.org/10.1016/j.pop.2018.05.004
Gandhi S, Ojha AK, Ranjan KP, Neelima. Clinical and bacteriological aspects of pyoderma. N Am J Med Sci. 2012; 4(10): 492–5. DOI: https://doi.org/10.4103/1947-2714.101997
Venniyil PV, Ganguly S, Kuruvila S, Devi S. Community-associated MRSA in pyoderma. Indian Dermatol Online J. 2016;7(3):159–63. DOI: https://doi.org/10.4103/2229-5178.182373
Umashankar N, Bhat G, Kuruvila M, Ganesh SP, Ravindra PB. MRSA in community-acquired pyoderma. Int J Dermatol. 2004; 43(6): 412–4. DOI: https://doi.org/10.1111/j.1365-4632.2004.02138.x
Sardana K, Manchanda V, Rajpal M, Garg VK, Chauhan DS. Bacterial pyoderma in children and MRSA management. Int J Dermatol. 2007; 46(3): 309-13. DOI: https://doi.org/10.1111/j.1365-4632.2007.03017.x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Dr Nadia Ghazanfar, Dr Sajida Bibi, Dr Muneeza Rizwan , Dr Maryam Rassul , Dr Lubna Rani Faysal, Dr Musafir Ali
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
