analysis of the distribution, drug susceptibility and drug resistance of staphylococcus aureus infection in the hainan area of china

Background : staphylococcus aureus causes skin, respiratory, and bloodstream infections; methicillin-resistant staphylococcus aureus (mrsa) presents major challenges due to multidrug resistance. hainan's high population mobility and uneven healthcare resources may influence the local epidemiology. this five-year inpatient dermatology study is warranted because skin and soft tissue infection (ssti)-focused, locality-specific data for hainan are scarce. it provides clinically actionable evidence by analyzing 1,515 isolates with year-over-year trends (including mrsa), directly informing empiric therapy and antimicrobial stewardship in this setting. objectives :the present study aimed to investigate the distribution, susceptibility, and drug resistance of s. aureus in hainan, china. methods :we conducted a retrospective study of 1,515 dermatology inpatients with skin or soft tissue s. aureus infection (january 2019 - december 2023). we summarized the clinical characteristics and annual susceptibility profiles. susceptibility interpretations followed clinical and laboratory standards institute (clsi) m100 guidance (2019: ed29; 2020: ed30; 2021: ed31; 2022: ed32; 2023: ed33). results :males comprised 58.90% - 69.54% annually. the lower limbs were the most commonly affected site (54.52% - 63.14%). secretions predominated as specimens (1,396/1,515; 92.15%). generalized eczema was common (39.95% - 47.46%). staphylococcus aureus exhibited persistently high penicillin resistance (87.6% - 93.78%; susceptibility: 6.22% - 12.4%) but retained useful susceptibility to amikacin, nitrofurantoin, linezolid, tigecycline, teicoplanin, and vancomycin. from 2019 - 2023, mrsa susceptibility to key agents (linezolid, vancomycin, teicoplanin, and tigecycline) remained greater than 30%; the yearly patterns were stable. conclusions :among hainan dermatology inpatients (2019 - 2023), s. aureus infections were predominantly in males and often involved the lower limbs and secretion specimens, with frequent generalized eczema. while penicillin resistance remains high, s. aureus — including mrsa — retains clinically meaningful susceptibility to several agents, supporting local empiric therapy and stewardship (largest regional cohort, n = 1,515).