title: Community-acquired methicillin-resistant Staphylococcus aureus skin infections: report of a local outbreak and implications for emergency department care.
abstract: OBJECTIVE
  To report a local outbreak of community-associated methicillin-resistant Staphylococcus aureas (CA-MRSA), discuss the incidence and the high rates of CA-MRSA-related skin and soft tissue infections in our outpatient and emergency department (ED) population, and also review the diagnosis and management of CA-MRSA in outpatients.
  
  
  METHODS
  Case report, diagnostic evidence, scientific literature, published treatment guidelines, and a retrospective chart review.
  
  
  CONCLUSIONS
  Clinical suspicions of high rates of CA-MRSA-related skin and soft tissue infections in our institution's outpatient and ED population was supported. Hospital-acquired MRSA (HA-MRSA) was also more prevalent than expected. Recognizing high-risk settings, patients and clinical features of CA-MRSA is essential for early identification and proper management. The most common clinical manifestation of CA-MRSA we identified was a skin or soft tissue infection.
  
  
  CONCLUSIONS
  It is important that clinicians have an awareness of high-risk patients, perform routine culturing of soft tissue infections, and prescribe antibiotics based on culture and sensitivities. Awareness, prevention, early diagnosis, and implementation of effective antibiotic management by nurse practitioners can help limit an epidemic of CA-MRSA.
authors.affiliation: Sharon Regional Health System, Kent State University, Ohio, USA. sflemin1@kent.edu
authors.forename: Scott W
authors.initials: SW
authors.lastname: Fleming
authors.forename: Lauren Hinson
authors.initials: LH
authors.lastname: Brown
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Tice
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D018563:Disease Notification; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D042241:Early Diagnosis; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D016106:Methicillin Resistance; D008826:Microbial Sensitivity Tests; D009722:Nurse Practitioners; D010414:Pennsylvania / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D011330:Prisons; D012189:Retrospective Studies; D012307:Risk Factors; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus
chemical_list: D000900:Anti-Bacterial Agents