title: A case of community-associated methicillin-resistant Staphylococcus aureus infections in a community hospital.
abstract: Infections caused by methicillin-resistant Staphylococcus Aureus (MRSA) have recently occurred in communities in people lacking known healthcare risk factors. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection, and is distinct from hospital-associated MRSA infection, which occurs in people with risk factors. We experienced a patient diagnosed with CA-MRSA cellulitis, as culture of pus revealed MRSA and he had not been exposed to healthcare environments for the past year. The patient was a previously healthy 38-year-old man with suppurative cellulitis in his right index finger following injury to the finger at his worksite. The cellulitis was successfully managed with incision and drainage (I&D), followed by cefazolin during a 10-day clinical course, although the patient's MRSA strain was resistant to cefazolin. There are several reports that suggest that I&D followed by antibiotic treatment for CA-MRSA skin infection produces equivalent clinical outcomes, whether the antibiotic prescribed was effective or not. Given that MRSA emerged in an outpatient setting, CA-MRSA should be considered a possible etiology of skin infection in healthy individuals with no classical risk factors for acquisition of MRSA.
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Hidenobu
authors: H
authors: Kawabata
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Manabu
authors: M
authors: Murakami
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Kengo
authors: K
authors: Kisa
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Yuya
authors: Y
authors: Kimura
authors: Department of Healthcare Systems Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Masaji
authors: M
authors: Maezawa
keywords: antibiotic treatment; colonization; community-associated methicillin-resistant Staphylococcus Aureus (CA-MRSA); incidence; skin and soft tissue infection
references: Emerg Infect Dis. 2007 Apr;13(4):594-600
references: 17553275
references: Clin Infect Dis. 2008 Mar 1;46(5):752-60
references: 18220477
references: J Emerg Med. 1985;3(3):227-32
references: 4093575
references: Arch Surg. 2004 Sep;139(9):947-51; discussion 951-3
references: 15381611
references: Lancet Infect Dis. 2005 Dec;5(12):751-62
references: 16310147
references: JAMA. 2003 Dec 10;290(22):2976-84
references: 14665659
references: Clin Infect Dis. 2005 Jan 1;40(1):100-7
references: 15614698
references: Antimicrob Agents Chemother. 2007 Oct;51(10):3591-8
references: 17682105
references: J Hosp Infect. 2006 Feb;62(2):241
references: 16289455
references: Clin Infect Dis. 2004 Oct 1;39(7):971-9
references: 15472848
references: Emerg Infect Dis. 2007 Feb;13(2):236-42
references: 17479885
references: Antimicrob Agents Chemother. 2006 Dec;50(12):4077-86
references: 17043124
references: Pediatrics. 2005 Mar;115(3):642-8
references: 15741366
references: Pediatr Infect Dis J. 2004 Feb;23(2):123-7
references: 14872177
references: N Engl J Med. 2005 Apr 7;352(14):1445-53
references: 15814880
references: J Clin Microbiol. 2005 Jul;43(7):3364-72
references: 16000461
references: N Engl J Med. 2001 Jan 4;344(1):11-6
references: 11136954
references: N Engl J Med. 2006 Aug 17;355(7):666-74
references: 16914702
references: J Clin Microbiol. 2006 Jul;44(7):2423-7
references: 16825359
references: Ann Intern Med. 2006 Mar 7;144(5):309-17
references: 16520471
references: N Engl J Med. 2002 Jun 13;346(24):1871-7
references: 12063371