Prevalence of and Factors Associated with MRSA among Patients with Hand Infection Treated in a Public Tertiary Hospital

Main Article Content

Tristan Jay I. Arellano, MD
https://orcid.org/0009-0004-8140-6914
Jessica Anne A. Gandionco, MD, FPOA
Madonna C. Morales-Valenzuela, MME
https://orcid.org/0000-0003-4470-0204

Abstract

Background: Methicillin-resistant Staphylococcus aureus (MRSA) poses significant challenges in managing hand infections, especially in resource-limited settings like the Philippines. Despite its global prevalence, data on MRSA-specific hand infections in Filipino patients remain scarce. This study aimed to determine the prevalence of MRSA and identify associated factors among patients treated for hand infections at a public tertiary hospital.


 


Methodology: A retrospective, cross-sectional study was conducted at Jose B. Lingad Memorial General Hospital from February 2022 to January 2024. Data from 233 patients treated for hand infections were analyzed. Variables examined included demographics, employment status, infection etiology, comorbidities, traditional medicine use, infection location, and classification. Statistical analyses were performed to identify associations with MRSA.


 


Result: MRSA prevalence was 30%, with bite wounds and use of traditional medicine showing significant associations (p = 0.002). Educational attainment was also linked to MRSA status, with unschooled individuals having a higher prevalence (p = 0.027). Other variables, such as age, gender, employment, comorbidities, and infection classification, showed no significant associations.


 


Conclusion: This study highlights the high prevalence of MRSA in hand infections, with traditional medicine use and bite wounds as key risk factors. The findings underscore the need for targeted educational campaigns, early intervention protocols for bite wounds, and community engagement to address traditional medicine practices. These measures could improve MRSA management and prevention in similar settings.


 


Keywords: Methicillin-resistant Staphylococcus aureus, hand infections, risk factors, traditional medicine, Philippines

Article Details

How to Cite
ARELLANO, T. J., Gandionco, J. A., & Valenzuela, M. (2025). Prevalence of and Factors Associated with MRSA among Patients with Hand Infection Treated in a Public Tertiary Hospital . Philippine Journal of Orthopaedics, 40(2), 26–31. https://doi.org/10.69472/poai.2025.18
Section
Original Articles
Author Biographies

Tristan Jay I. Arellano, MD, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines

Department of Orthopaedics, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines 

Jessica Anne A. Gandionco, MD, FPOA, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines

Hand Consultant, Department of Orthopaedics, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines

Madonna C. Morales-Valenzuela, MME, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines

Statistician III, Data Analytics Unit, Jose B. Lingad Memorial General Hospital, San Fernando, Pampanga, Philippines

References

Flevas DA, Syngouna S, Fandridis E, Tsiodras S, Mavrogenis AF. Infections of the hand: an overview. EFORT Open Rev. 2019;4(5):183-93. https://pubmed.ncbi.nlm.nih.gov/31191986 https://pmc.ncbi.nlm.nih.gov/articles/PMC6540949 https://doi.org/10.1302/2058-5241.4.180082

Schmidt G, Piponov H, Chuang D, Gonzalez M. Hand infections in the immunocompromised patient: an update. J Hand Surg Am. 2019;44(2):144-9.

McDonald LS, Bavaro MF, Hofmeister EP, Kroonen LT. Hand infections. J Hand Surg Am. 2011 Aug;36(8):1403-12. https://pubmed.ncbi.nlm.nih.gov/30145028 https://doi.org/10.1016/j.jhsa.2018.07.001

Koshy JC, Bell B. Hand infections. J Hand Surg Am. 2019;44(1):46-54. https://pubmed.ncbi.nlm.nih.gov/30017648 https://doi.org/10.1016/j.jhsa.2018.05.027

Kistler JM, Thoder JJ, Ilyas AM. MRSA incidence and antibiotic trends in urban hand infections: a 10-year longitudinal study. Hand (NY). 2019;14(4):449-54. https://pubmed.ncbi.nlm.nih.gov/29322874 https://pmc.ncbi.nlm.nih.gov/articles/PMC6760093 https://doi.org/10.1177/1558944717750921

Tosti R, Samuelsen BT, Bender S, et al. Emerging multidrug resistance of methicillin-resistant Staphylococcus aureus in hand infections. J Bone Joint Surg Am. 2014;96(18):1535-40. https://pubmed.ncbi.nlm.nih.gov/25232077 https://doi.org/10.2106/JBJS.M.01159

Hidron AI, Edwards JR, Patel J, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2006–2007. Infect Control Hosp Epidemiol. 2008;29(11):996-1011. https://pubmed.ncbi.nlm.nih.gov/18947320 https://doi.org/10.1086/591861

Malizos KN, Papadopoulou ZK, Ziogkou AN, et al. Infections of deep hand and wrist compartments. Microorganisms. 2020;8(6):838. https://pubmed.ncbi.nlm.nih.gov/32503146 https://pmc.ncbi.nlm.nih.gov/articles/PMC7356554 https://doi.org/10.3390/microorganisms8060838

Ayers SL, Kronenfeld JJ. Delays in seeking conventional medical care and complementary and alternative medicine utilization. Health Serv Res. 2012;47(5):2081-96. https://pubmed.ncbi.nlm.nih.gov/22985034 https://pmc.ncbi.nlm.nih.gov/articles/PMC3513619 https://doi.org/10.1111/j.1475-6773.2012.01406.x

Capuno JJ, Kraft AD, Poco LC, Quimbo SA, Tan CAR Jr. Health conditions, payments, proximity, and opportunity costs: Examining delays in seeking inpatient and outpatient care in the Philippines. Soc Sci Med. 2019;238:112479. https://pubmed.ncbi.nlm.nih.gov/31421350 https://doi.org/10.1016/j.socscimed.2019.112479

Yeh C, Kapila R, Schwartz RA. Nontropical diabetic hand syndrome: A troubling new entity. Dermatol Ther. 2019;32(6):e13125. https://pubmed.ncbi.nlm.nih.gov/31631451 https://doi.org/10.1111/dth.13125

Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute hand infections. Am Fam Physician. 2019;99(4):228-36. https://pubmed.ncbi.nlm.nih.gov/31631451 https://doi.org/10.1111/dth.13125

Klevens RM, Morrison MA, Nadle J, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA. 2007;298(15):1763-71. https://pubmed.ncbi.nlm.nih.gov/17940231 https://doi.org/10.1001/jama.298.15.1763

Hausman MR, Lisser SP. Hand infections. Orthop Clin North Am. 1992;23(1):171-85. https://pubmed.ncbi.nlm.nih.gov/1729665

Patil PD, Panchabhai TS, Galwankar SC. Managing human bites. J Emerg Trauma Shock. 2009;2(3):186-90. https://pubmed.ncbi.nlm.nih.gov/ 20009309 https://pmc.ncbi.nlm.nih.gov/articles/PMC2776367 https://doi.org/10.4103/0974-2700.55331

Sharma K, Pan D, Friedman J, Yu JL, Mull A, Moore AM. Quantifying the effect of diabetes on surgical hand and forearm infections. J Hand Surg Am. 2018;43(2):105-14. https://pubmed.ncbi.nlm.nih.gov/29241843 https://doi.org/10.1016/j.jhsa.2017.11.003

Shedoeva A, Leavesley D, Upton Z, Fan C. Wound healing and the use of medicinal plants. Evid Based Complement Alternat Med. 2019;1:2684108. https://pubmed.ncbi.nlm.nih.gov/31662773 https://pmc.ncbi.nlm.nih.gov/articles/PMC6778887 https://doi.org/10.1155/2019/2684108

Houshian S, Seyedipour S, Wedderkopp N. Epidemiology of bacterial hand infections. Int J Infect Dis. 2006;10(4):315-9. https://pubmed.ncbi.nlm.nih.gov/16483816 https://doi.org/10.1016/j.ijid.2005.06.009

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