Community-acquired methicillin-resistant Staphylococcus aureus in institutionalized adults with developmental disabilities.
Methicillin-resistant Staphylococcus aureus (MRSA) has recently been reported to emerge in the community setting. We describe the investigation and control of a community-acquired outbreak of MRSA skin infections in a closed community of institutionalized adults with developmental disabilities. In a 9-month period in 1997, 20 (71%) of 28 residents had 73 infectious episodes. Of the cultures, 60% and 32% obtained from residents and personnel, respectively, grew S. aureus; 96% and 27% were MRSA. All isolates were genetically related by pulsed-field gel electrophoresis and belonged to a phage type not previously described in the region. No known risk factors for MRSA acquisition were found. However, 58 antibiotic courses had been administered to 16 residents during the preceding 9 months. Infection control measures, antibiotic restriction, and appropriate therapy resulted in successful termination of this outbreak. Selective antibiotic pressure may result in the emergence, persistence, and dissemination of MRSA strains, causing prolonged disease.
Soroka University Medical Center and the Ben-Gurion University of the Negev, Beer-Sheva, Isreal.
Abraham
A
Borer
Jacob
J
Gilad
Pablo
P
Yagupsky
Nechama
N
Peled
Nurith
N
Porat
Ronit
R
Trefler
Hannah
H
Shprecher-Levy
Klaris
K
Riesenberg
Miriam
M
Shipman
Francisc
F
Schlaeffer
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002353:Carrier State / Q000188:drug therapy / Q000382:microbiology; D017714:Community-Acquired Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D002658:Developmental Disabilities / Q000150:complications*; D004196:Disease Outbreaks / Q000517:prevention & control; D006801:Humans; D017053:Infection Control; D007326:Institutionalization; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification
D000900:Anti-Bacterial Agents