Epidemiology and Infection

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Epidemiology and Infection (2010), 138:313-317 Cambridge University Press
Copyright © Cambridge University Press 2009

Short Report

Staphylococcus aureus is the most common identified cause of cellulitis: a systematic review

S. CHIRAa1 and L. G. MILLERa2 c1

a1 Alpert Medical School at Brown University, Providence, RI, USA
a2 Harbor–UCLA Medical Center, Division of Infectious Diseases, Torrance, CA, USA
Article author query
chira s [PubMed]  [Google Scholar]
miller lg [PubMed]  [Google Scholar]


We utilized Medline to perform a systematic review of the literature to quantify the aetiology of cellulitis with intact skin. Of 808 patients with cellulitis, 127–129 (15·7–16·0%) patients had positive needle aspiration and/or punch biopsy cultures from intact skin. Of the patients with positive cultures, 65 (50·4–51·2%) had cultures positive for Staphylococcus aureus, 35 (27·1–27·6%) for group A streptococcus, and 35–37 (27·1–29·1%) for other pathogens. The most common aetiology of cellulitis with intact skin, when it can be determined, is S. aureus, outnumbering group A streptococcus by a ratio of nearly 2:1. Given the increasing incidence of community-associated methicillin-resistant S. aureus infections, our findings may have critical therapeutic implications.

(Accepted July 01 2009)

(Online publication August 03 2009)

Key Words:Cellulitis aetiology; systematic review


c1 Author for correspondence: L. G. Miller, M.D., M.P.H., Division of Infectious Diseases, Harbor–UCLA Medical Center, 1000 W Carson St, Bin 466, Torrance, CA 90509, USA. (Email: lgmiller@ucla.edu)