Medical Student Research Fellowship for Summer 2005

Mentor: Daniel Skiest, M.D.
Department: Internal Medicine/ Infectious Diseases
Room number: Y7.312
Mail Code: 9113
Phone number: 214 648-9022
E-mail: Daniel.skiest@utsouthwestern.edu
Project title: Treatment outcomes in patients with skin and soft tissue infections due to community acquired MRSA

Human subjects IRB approved project number (where applicable): pending

Animal subjects IRB approved project number (where applicable): NA

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)

Patient Based research

Brief Description of Project:

Recently several studies have documented the increasing prevalence of methicilln resistant S. aureus (MRSA) as a cause of community acquired infections, primarily skin and soft tissue infections (SSTIs). The optimal treatment of patients with SSTIs due to MRSA has not been determined.
This study will compare trimethoprim/sulfamethoxazole to minocycline for the treatment of patients with skin and skin structure focal infections caused by S. aureus. requiring incision and drainage and packing. Eligible patients will be those presenting to the ACC clinic or ER with a SSTI requiring incision and drainage with packing and not requiring hospitalization. Patients will be randomized to receive either trimethoprim/sulfamethoxazole or minocycline. The primary study endpoint will be cure or improvement of signs and symptoms of SSTI at day 3. Patients will be stratified by lesion size. Resolution of infection will be based on assessment of lesion size, presence of purulence, presence of new lesions, presence of fever, chills, WBC and positive blood culture for the same organism cultured from the primary lesion.
The student will be responsible for enrolling the patients, subject evaluation, and data collection. The student will also be involved in data analysis and manuscript preparation.

Previous Research Activities or Publications with Medical Students:

In bold I have noted publications with medical students. In italics I have noted resident co-authored publications.

1. Skiest DJ, Rubinstien E, Carley N, Gioiella L, Lyons R. The Importance of Comorbidity in HIV Infected Patients Over 55: A Retrospective Case-Control Study. Am J Med 1996;101:605-611

2. Skiest D, Erdman W, Chang W, Oz O, Fleckenstein J. SPECT Thallium-201 combined with Toxoplasma Serology for the Presumptive Diagnosis of CNS Mass Lesions in Patients with AIDS. J Infection 2000; 40:274-81.

3. Scribner A, Troia-Cancio P, Cox B, Marcantonio D, Hamid F, Keiser P, Levi M, Allen B, Murphy K, Jones RE, Skiest DJ. Osteonecrosis in HIV: A Case-Control Study. J Acquir Immune Defic Syndr Hum Retrovirol. 2000;25:19-25.

4. Skiest DJ, Chiller T, Chiller K, Park A, Keiser P. Protease Inhibitor therapy is associated with markedly prolonged time to relapse and improved survival in AIDS patients with CMV retinitis. Int J STD and AIDS. 2001;12 (10):659-664.

5. Reddy ST, Jain MK, Horan K, Skiest DJ, Gander RM. Gonococcal Retropharyngeal Abscess Complicated by Cervival Osteomyelitis in a Patient with AIDS. Infect Dis Clin Pract 2001; 275-278

6. Wei LL, Park SS, Skiest DJ. Prevalence of Visual Symptoms Among Patients with Newly Diagnosed Cytomegalovirus Retinitis. RETINA 2002;22(3):278-282

7. Jain MK, Skiest DJ, Cloud JW, Jain CL, Burns, D, Berggren RE. Changes in HIV-Related Mortality: Analysis of In-Patient Deaths in 1995 Compared to 1999-2000. Clinical Infectious Diseases 2003;36:1030

8. Song J, Skiest, DJ, Safar AN, Edwards AO. PCR for Etiologically Equivocal Retinitis in HIV Patients without CD4 Depletion. Journal of the Korean American Medical Assocation. 2003;9:83-88

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