An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska.

Abstract

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: Henry C Baggett, Thomas W Hennessy, Richard Leman, Cindy Hamlin, Dana Bruden, Alisa Reasonover, Patricia Martinez, Jay C Butler
• Journal: Infection control and hospital epidemiology (Infect Control Hosp Epidemiol) Vol. 24 Issue 6 Pg. 397-402 (Jun 2003) ISSN: 0899-823X [Print] United States
• PMID: 12828314 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-Bacterial Agents

Topics

• Adolescent
• Adult
• Aged
• Alaska (epidemiology)
• Anti-Bacterial Agents (therapeutic use)
• Child
• Child, Preschool
• Cohort Studies
• Community-Acquired Infections (epidemiology)
• Disease Outbreaks
• Female
• Humans
• Infant
• Male
• Methicillin Resistance
• Middle Aged
• Retrospective Studies
• Rural Population
• Staphylococcal Skin Infections (drug therapy, epidemiology, microbiology)
• Staphylococcus aureus (isolation & purification)