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Previous Volume 352:1436-1444 April 7, 2005 Number 14 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Chambers, H. F. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear Related Article PubMed Citation

ABSTRACT

Background Methicillin-resistant Staphylococcus aureus (MRSA) infection has emerged in patients who do not have the established risk factors. The national burden and clinical effect of this novel presentation of MRSA disease are unclear.

Methods We evaluated MRSA infections in patients identified from population-based surveillance in Baltimore and Atlanta and from hospital-laboratory–based sentinel surveillance of 12 hospitals in Minnesota. Information was obtained by interviewing patients and by reviewing their medical records. Infections were classified as community-acquired MRSA disease if no established risk factors were identified.

Results From 2001 through 2002, 1647 cases of community-acquired MRSA infection were reported, representing between 8 and 20 percent of all MRSA isolates. The annual disease incidence varied according to site (25.7 cases per 100,000 population in Atlanta vs. 18.0 per 100,000 in Baltimore) and was significantly higher among persons less than two years old than among those who were two years of age or older (relative risk, 1.51; 95 percent confidence interval, 1.19 to 1.92) and among blacks than among whites in Atlanta (age-adjusted relative risk, 2.74; 95 percent confidence interval, 2.44 to 3.07). Six percent of cases were invasive, and 77 percent involved skin and soft tissue. The infecting strain of MRSA was often (73 percent) resistant to prescribed antimicrobial agents. Among patients with skin or soft-tissue infections, therapy to which the infecting strain was resistant did not appear to be associated with adverse patient-reported outcomes. Overall, 23 percent of patients were hospitalized for the MRSA infection.

Conclusions Community-associated MRSA infections are now a common and serious problem. These infections usually involve the skin, especially among children, and hospitalization is common.

Source Information

From the Division of Bacterial and Mycotic Diseases (S.K.F.) and Division of Healthcare Quality Promotion (J.C.H., M.M., J.A.J.), National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta; Emory University School of Medicine and the Veterans Affairs Medical Center, Atlanta (M.M., J.A.J., M.M.F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore (L.T.S., L.H.H.); and the Minnesota Department of Health, Minneapolis (K.C.-S., K.H., R.L.).

Address reprint requests to Dr. Fridkin at the CDC, NCID, DBMD, MDB, MS C-09, 1600 Clifton Rd., NE, Atlanta, GA 30333, or at skf0{at}cdc.gov.

Full Text of this Article

Related Letters:

MRSA in the Community
Chapman A. L.N., Greig J. M., Innes J. A., Hageman J. C., Lynfield R., Fridkin S. K., Miller L. G., Perdreau-Remington F., Spellberg B.
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N Engl J Med 2005; 353:530-532, Aug 4, 2005. Correspondence

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