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Infection Control and Hospital Epidemiology Publication Info

Article DOI: 10.1086/502221
Stable URL: http://www.jstor.org/stable/10.1086/502221
An Outbreak of Community‐Onset Methicillin‐Resistant Staphylococcus aureus Skin Infections in Southwestern Alaska • 
Henry C. Baggett , MD, Thomas W. Hennessy , MD, MPH, Richard Leman , MD, Cindy Hamlin , RN, Dana Bruden , MS, Alisa Reasonover , BS, Patricia Martinez , MD and Jay C. Butler , MD
Infection Control and Hospital Epidemiology , Vol. 24, No. 6 (June 2003), pp. 397-402
Article DOI: 10.1086/502221
Article Stable URL: http://www.jstor.org/stable/10.1086/502221
Original Articles

An Outbreak of Community‐Onset Methicillin‐Resistant Staphylococcus aureus Skin Infections in Southwestern Alaska

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Abstract(back to top)

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 betalactam antimicrobial agents not be used as a first‐line therapy for suspected S. aureus infections.

Bibliographic Information(back to top)

  • An Outbreak of Community‐Onset Methicillin‐Resistant Staphylococcus aureus Skin Infections in Southwestern Alaska
  • Henry C. Baggett , MD, Thomas W. Hennessy , MD, MPH, Richard Leman , MD, Cindy Hamlin , RN, Dana Bruden , MS, Alisa Reasonover , BS, Patricia Martinez , MD and Jay C. Butler , MD
  • Infection Control and Hospital Epidemiology
  • Vol. 24, No. 6 (June 2003) (pp. 397-402)

Author Information(back to top)

Henry C. Baggett , MD; Thomas W. Hennessy , MD, MPH; Richard Leman , MD; Cindy Hamlin , RN; Dana Bruden , MS; Alisa Reasonover , BS; Patricia Martinez , MD; Jay C. Butler , MD

Notes and References(back to top)

This item contains 1 note(s).

Notes

Drs. Baggett, Hennessy, and Butler and Ms. Hamlin, Ms. Bruden, and Ms. Reasonover are from the Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska. Drs. Baggett and Leman are from the Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia. Dr. Leman is also from the Indian Health Service, Albuquerque, New Mexico. Dr. Martinez is from the Yukon‐Kuskokwim Health Corporation, Bethel, Alaska.Address reprint requests to Henry C. Baggett, MD, CDC/Arctic Investigations Program, 4055 Tudor Centre Drive, Anchorage, AK 99508.Supported by the National Center for Infectious Diseases, Antimicrobial Resistance Working Group, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.The authors thank the Yukon‐Kuskokwim Health Corporation (YKHC) for their support of this work with a special thanks to Dr. Joseph Klejka. The authors also thank Gayle Jones and the YKHC laboratory staff for their assistance navigating the laboratory databases; Linda Russell for her MRSA surveillance updates; Drs. Alan Parkinson and Jim Cheek for their advice on project planning; Dr. Michael Bruce for his assistance with data analysis; Dr. Karen Rudolph, Rachel Sparks, and Carolynn DeByle for performing all mecA testing; and Drs. Scott Fridkin and Julie Gerberding for sharing their expertise in the area of community‐acquired MRSA epidemiology.

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© 2003 by The Society for Healthcare Epidemiology of America. All rights reserved.