Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community.
In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%). In multivariate analysis, sauna use [odds ratio (OR) 19.1, 95% confidence interval (CI) 2.7-206.1] and antimicrobial use within 12 months before infection (OR 11.7, 95% CI 2.9-47.6) were risk factors for infection. MRSA nasal carriage rate was 0.6% (1/174). Nine of 10 clinical isolates and an isolate from an administrative office within the community had the pulsed-field gel electrophoresis type USA300. Targeted hygiene improvement, wound care, and environmental cleaning were implemented. We describe the first reported outbreak of MRSA SSTI in a religious community. Adherence to appropriate personal and environmental hygiene might be critical factors in controlling transmission.
Coronado
F
F
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. fcoronado@cdc.gov
Nicholas
J A
JA
Wallace
B J
BJ
Kohlerschmidt
D J
DJ
Musser
K
K
Schoonmaker-Bopp
D J
DJ
Zimmerman
S M
SM
Boller
A R
AR
Jernigan
D B
DB
Kacica
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000517:prevention & control; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D006920:Hygiene; D007223:Infant; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009297:Nasal Mucosa / Q000382:microbiology; D012067:Religion; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000517:prevention & control; D013207:Staphylococcal Skin Infections / Q000453:epidemiology* / Q000517:prevention & control