title: Community-based intervention to manage an outbreak of MRSA skin infections in a county jail.
abstract: This article describes a community-based intervention to manage an outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections in a midwestern county jail. A systematic investigation conducted by a family medicine residency program identified 64 total cases and 19 MRSA cases between January 1 and December 31, 2007. Factors contributing to MRSA transmission included inadequate surveillance, lack of antibacterial soap, and a defective laundry process. All 19 isolates were CA-MRSA and all seven tested by pulsed-field gel electrophoresis (PFGE) were USA300. Four of the seven isolates showed variation of their PFGE patterns. A primary care approach using community-based resources effectively reduced the number of cases in this heterogeneous outbreak of CA-MRSA, with the last MRSA being isolated in October 2007.
authors.affiliation: Sioux Falls Family Medicine Program, Center for Family Medicine, Sioux Falls, South Dakota, USA. aelias2@jhmi.edu
authors.forename: Abdallah F
authors.initials: AF
authors.lastname: Elias
authors.forename: Michael S
authors.initials: MS
authors.lastname: Chaussee
authors.forename: Emily J
authors.initials: EJ
authors.lastname: McDowell
authors.forename: Mark K
authors.initials: MK
authors.lastname: Huntington
mesh_terms: D000328:Adult; D015373:Bacterial Typing Techniques; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D004282:Documentation; D016521:Electrophoresis, Gel, Pulsed-Field; D005194:Family Practice / Q000193:education / Q000458:organization & administration; D005260:Female; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D007396:Internship and Residency / Q000458:organization & administration; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015146:Midwestern United States; D010802:Phylogeny; D011320:Primary Health Care / Q000458:organization & administration; D011330:Prisons / Q000458:organization & administration; D015397:Program Evaluation; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D004269:DNA, Bacterial
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