OBJECTIVE: We investigated a large outbreak of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections in southwestern Alaska to determine the extent of these infections and whether MRSA isolates were likely community acquired. DESIGN: Retrospective cohort study. SETTING: Rural southwestern Alaska. PATIENTS: All patients with a history of culture-confirmed S. aureus infection from March 1, 1999, through August 10, 2000. RESULTS: More than 80% of culture-confirmed S. aureus infections were methicillin resistant, and 84% of MRSA infections involved skin or soft tissue; invasive disease was rare. Most (77%) of the patients with MRSA skin infections had community-acquired MRSA (no hospitalization, surgery, dialysis, indwelling line or catheter, or admission to a long-term-care facility in the 12 months before infection). Patients with MRSA skin infections were more likely to have received a prescription for an antimicrobial agent in the 180 days before infection than were patients with methicillin-susceptible S. aureus skin infections. CONCLUSIONS: Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.
OBJECTIVE: We investigated a large outbreak of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections in southwestern Alaska to determine the extent of these infections and whether MRSA isolates were likely community acquired. DESIGN: Retrospective cohort study. SETTING: Rural southwestern Alaska. PATIENTS: All patients with a history of culture-confirmed S. aureus infection from March 1, 1999, through August 10, 2000. RESULTS: More than 80% of culture-confirmed S. aureus infections were methicillin resistant, and 84% of MRSA infections involved skin or soft tissue; invasive disease was rare. Most (77%) of the patients with MRSA skin infections had community-acquired MRSA (no hospitalization, surgery, dialysis, indwelling line or catheter, or admission to a long-term-care facility in the 12 months before infection). Patients with MRSA skin infections were more likely to have received a prescription for an antimicrobial agent in the 180 days before infection than were patients with methicillin-susceptible S. aureus skin infections. CONCLUSIONS: Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.
Authors: Sanjay K Shukla; Mary E Stemper; Srinivas V Ramaswamy; Jennifer M Conradt; Robert Reich; Edward A Graviss; Kurt D Reed Journal: J Clin Microbiol Date: 2004-08 Impact factor: 5.948
Authors: F Coronado; J A Nicholas; B J Wallace; D J Kohlerschmidt; K Musser; D J Schoonmaker-Bopp; S M Zimmerman; A R Boller; D B Jernigan; M A Kacica Journal: Epidemiol Infect Date: 2006-07-26 Impact factor: 2.451
Authors: Robert C Holman; Aaron T Curns; Rosalyn J Singleton; James J Sejvar; Jay C Butler; Edna L Paisano; Lawrence B Schonberger; James E Cheek Journal: Public Health Rep Date: 2006 Nov-Dec Impact factor: 2.792
Authors: Thomas W Hennessy; Troy Ritter; Robert C Holman; Dana L Bruden; Krista L Yorita; Lisa Bulkow; James E Cheek; Rosalyn J Singleton; Jeff Smith Journal: Am J Public Health Date: 2008-04-01 Impact factor: 9.308