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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
DOI: 10.1086/502221
Stable URL: http://www.jstor.org/stable/10.1086/502221
Page Count: 6
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An Outbreak of Community‐Onset Methicillin‐Resistant Staphylococcus aureus Skin Infections in Southwestern Alaska
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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 betalactam antimicrobial agents not be used as a first‐line therapy for suspected S. aureus infections.

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