Epidemiology of methicillin-resistant Staphylococcus aureus among incarcerated population in Hawai'i, 2000-2005.

It is estimated in this study the proportion and incidence of MRSA among the entire state of Hawai'i inmate population over a period of six years, using a statewide, population-based antimicrobial resistance surveillance system. Trend analyses were conducted on both MRSA proportion and MRSA incidence rates including MRSA patterns of antimicrobial resistance to other antibiotics. During the period from 2000 to 2005, 521 (69%) of 753 S. aureus isolates were MRSA. A significant increase in the proportion of MRSA were identified from both jail and prison inmates (p < 0.01). A significant increase in MRSA incidence was also observed among jail inmates (p = 0.005) but not among prison inmates (p = 0.18). A majority of non-beta-lactams, including clindamycin, tetracycline, and trimethoprim-sulfamethoxazole remained as a good choice for the treatment of MRSA infections among inmate population in Hawai'i. Active surveillance of MRSA infection in the inmate population is an important public health tool and should be continued.