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

Published online by Cambridge University Press:  02 January 2015

Henry C. Baggett ,
Thomas W. Hennessy ,
Richard Leman ,
Cindy Hamlin ,
Dana Bruden ,
Alisa Reasonover ,
Patricia Martinez  and
Jay C. Butler
Henry C. Baggett*
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
Thomas W. Hennessy
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
Richard Leman
Affiliation:
Epidemic Intelligence Service, Division of Applied Public Health Training, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Indian Health Service, Albuquerque, New Mexico
Cindy Hamlin
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
Dana Bruden
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
Alisa Reasonover
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
Patricia Martinez
Affiliation:
Yukon-Kuskokwim Health Corporation, Bethel, Alaska
Jay C. Butler
Affiliation:
Arctic Investigations Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, Alaska
*
CDC/Arctic Investigations Program, 4055 Tudor Centre Drive, Anchorage, AK 99508
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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 communityacquired 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.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 6 , June 2003 , pp. 397 - 402
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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